International Ophthalmology

, Volume 28, Issue 1, pp 7–17 | Cite as

A randomized, placebo-controlled clinical trial of intravitreal triamcinolone for refractory diabetic macular edema

  • Mohammad H. Dehghan
  • Hamid Ahmadieh
  • Alireza Ramezani
  • Morteza Entezari
  • Arash Anisian
Original paper


Purpose To evaluate the effect of intravitreal triamcinolone acetonide (IVT) on refractory diabetic macular edema (DME). Methods In a prospective, placebo-controlled, randomized clinical trial, 88 eyes of 61 patients with clinically significant macular edema that would have responded unfavourably to laser photocoagulation were randomly assigned to two groups. The treatment group (45 eyes) received 4 mg IVT and the control group (43 eyes) received a placebo subconjunctival injection. The primary outcome was central macular thickness (CMT) measured by optical coherence tomography. Complete examination was repeated at 2 and 4 months post-intervention. Results The mean (SD) CMT before the intervention and at the 2- and 4-month follow-ups was 393 (151), 293 (109) and 362 (119) μm in the treatment group and 393 (166), 404 (134) and 405 (160) μm in the placebo group, respectively. The second month difference was significant (P = 0.01). The difference between visual acuity changes (0.15 logarithm of the minimum angle of resolution, logMAR) was significant at 2 months (P = 0.02) but reduced to 0.11 logMAR (P = 0.08) after 4 months. Reduction for hard exudates and petaloid pattern were significantly greater in cases at 4 months. Conclusions The therapeutic effect of IVT on DME is greatest at 2 months and decreases up to the fourth month post-intervention. However, in terms of cystoid macular edema and hard exudates, the effect is maintained up to 4 months.


Cystoid macular edema Diabetic macular edema Hard exudates Intravitreal triamcinolone Macular thickness 



Blood urea nitrogen


Cystoid macular edema


Central macular thickness


Clinically significant macular edema


Diabetic macular edema


Early treatment diabetic retinopathy study


Fasting blood sugar


Hard exudates


Intraocular pressure


Logarithm of the minimum angle of resolution


Macular photocoagulation


Neovascularization of iris


Optical coherence tomography


Panretinal photocoagulation


Visual acuity



This study was supported by the Ophthalmic Research Centre of Shaheed Beheshti Medical University.


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Copyright information

© Springer Science+Business Media B.V. 2007

Authors and Affiliations

  • Mohammad H. Dehghan
    • 1
  • Hamid Ahmadieh
    • 1
  • Alireza Ramezani
    • 1
  • Morteza Entezari
    • 1
  • Arash Anisian
    • 1
  1. 1.Ophthalmic Research Centre of Shaheed Beheshti Medical University, Labbafinejad Medical CentreTehranIran

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