Intravitreal diclofenac versus intravitreal triamcinolone acetonide in the treatment of diabetic macular edema

Retina. 2011 Nov;31(10):2058-64. doi: 10.1097/IAE.0b013e31822a042a.

Abstract

Purpose: To compare the efficacy and safety of intravitreal diclofenac versus intravitreal triamcinolone acetonide in the treatment of diabetic macular edema.

Methods: Thirty-two eyes with diffuse diabetic macular edema were randomly allocated to intravitreal injection of 4 mg/0.1 mL of triamcinolone (Group 1: N = 16) or 500 μg/0.1 mL of diclofenac (Group 2: N = 16). Preoperative and postoperative visual acuity, intraocular pressure, and central macular thickness were recorded and compared between the 2 groups up to 12 weeks.

Results: Both groups showed statistically significant reduction in central macular thickness (triamcinolone: P = 0.02 and diclofenac: P = 0.01), without statistically significant difference between the 2 groups. Visual improvement was significant only in triamcinolone group (P = 0.05). However, the 2 groups showed no statistically significant difference in mean visual acuity or mean line improvement. Transient elevation of intraocular pressure occurred in 12.5% of the triamcinolone group. Diclofenac group showed statistically significant reduced intraocular pressure (P = 0.02).

Conclusion: Intravitreal diclofenac is effective in the treatment of diffuse diabetic macular edema up to 12 weeks. Intravitreal triamcinolone and diclofenac appear to have comparable therapeutic effects on retinal thickness. The degree of visual improvement is higher with triamcinolone.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Anti-Inflammatory Agents, Non-Steroidal / adverse effects
  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use*
  • Diabetic Retinopathy / drug therapy*
  • Diabetic Retinopathy / physiopathology
  • Diclofenac / adverse effects
  • Diclofenac / therapeutic use*
  • Female
  • Glucocorticoids / adverse effects
  • Glucocorticoids / therapeutic use*
  • Humans
  • Intraocular Pressure / physiology
  • Intravitreal Injections
  • Macula Lutea / pathology
  • Macular Edema / drug therapy*
  • Macular Edema / physiopathology
  • Male
  • Middle Aged
  • Tomography, Optical Coherence
  • Treatment Outcome
  • Triamcinolone Acetonide / adverse effects
  • Triamcinolone Acetonide / therapeutic use*
  • Visual Acuity / physiology

Substances

  • Anti-Inflammatory Agents, Non-Steroidal
  • Glucocorticoids
  • Diclofenac
  • Triamcinolone Acetonide