DefinePK

Research Objective

To assess the efficacy of suprachoroidal versus intravitreal injection of triamcinolone in diabetic macular edema.

Methodology

A prospective randomized controlled trial was conducted on 71 eyes of 59 patients diagnosed with Diabetic Macular Edema (DME). Patients were divided into two groups: Group A received suprachoroidal triamcinolone, and Group B received intravitreal triamcinolone. Visual acuity, intraocular pressure (IOP), and macular thickness (measured by OCT) were assessed pre-operatively and at follow-up visits (1 week, 1, 3, and 6 months). Data was analyzed using SPSS version 23, with quantitative variables presented as mean ± standard deviation and qualitative variables as frequency and percentage. Comparative data was analyzed using Chi-square test, and follow-up parameters were compared using ANOVA.

Methodology Flowchart

                        graph TD
    A["Patient Recruitment DME diagnosis"] --> B["Informed Consent"];
    B --> C["Randomization"];
    C --> D["Group A: Suprachoroidal Triamcinolone"];
    C --> E["Group B: Intravitreal Triamcinolone"];
    D --> F["Pre-operative Assessment BCVA, IOP, OCT"];
    E --> F;
    F --> G["Procedure Injection"];
    G --> H["Post-operative Assessment IOP, Fundus Exam"];
    H --> I["Follow-up Visits 1 week, 1, 3, 6 months"];
    I --> J["Assessments at Follow-up BCVA, IOP, OCT"];
    J --> K["Data Analysis"];
    K --> L["Conclusion"];                    

Discussion

The study supports the efficacy of both suprachoroidal triamcinolone acetonide (SCTA) and intravitreal triamcinolone acetonide (IVTA) in treating DME. However, SCTA demonstrated advantages in managing IOP and maintaining a more stable response over time, with fewer side effects like glaucoma and cataract compared to IVTA. Previous studies are cited to support these findings, highlighting SCTA's potential for longer duration of effectiveness and reduced adverse events.

Key Findings

Both suprachoroidal and intravitreal triamcinolone injections showed significant improvement in visual acuity and macular thickness in patients with DME, with the most notable improvement observed in the 3rd month. The suprachoroidal injection group exhibited a more stable response and a lower complication rate, particularly regarding intraocular pressure (IOP), which was significantly higher in the intravitreal group at the 3rd month. Macular thickness showed a more substantial reduction in the suprachoroidal group compared to the intravitreal group at later follow-up visits.

Conclusion

Both suprachoroidal and intravitreal triamcinolone acetonide are effective in treating diabetic macular edema. However, suprachoroidal injection is considered the treatment of choice due to its superior management of intraocular pressure, longer duration of action, and fewer associated side effects such as glaucoma and cataract compared to intravitreal injection.

Fact Check

1. The study period was from 1st November 2022 to 30th October 2023. (Confirmed in Methods section)
2. The study included 71 eyes of 59 patients. (Confirmed in Abstract and Results section)
3. The average age of patients in both groups was 43.6±6.2 years. (Confirmed in Abstract and Results section)

Mind Map