The influence of intravitreally applied triamcinolone acetonide on vitreal hemorrhage resorption and visual acuity in patients with proliferative diabetic retinopathy

Abstract

© 2018, Serbia Medical Society. All rights reserved. Introduction/Objective Vitreal hemorrhage is one of the possible complications of diabetic retinopathy, followed by intensive decrease of visual acuity. Corticosteroids are commonly used in treatment of different retinal diseases, due to their anti-inflammatory and anti-angiogenetic effect. Triamcinolone acetonide applied intravitreally remains in the eye for several months, releases its crystals, and decreases the density of vitreal hemorrhage. The main goal of this study is to evaluate the efficacy of 20 mg intravitreal triamcinolone acetonide for the management of long-lasting vitreal hemorrhage, occurred as a complication of proliferative diabetic retinopathy in non-vitrectomized eyes. Methods In a prospective study performed between January 1, 2015 and January 1, 2016, 24 patients with vitreal hemorrhage who received intravitreal triamcinolone acetonide were compared to 21 patients from the control group. The control group consisted of patients with proliferative diabetic retinopathy and similar degree of vitreal hemorrhage. All the patients underwent an ophthalmological examination at the beginning of the study, seven days, one, three, six, nine, and 12 months after intravitreal administration of 20 mg of triamcinolone acetonide. In addition to vitreal hemorrhage and visual acuity, intraocular pressure and cataract development were also analyzed. Results Statistically significant difference in the density of vitreal hemorrhage and visual acuity was recorded during the first and the third month after administering triamcinolone. Twenty-nine percent of the patients had a temporary rise in intraocular pressure after intravitreal triamcinolone application, and 4.1% of the patients finished the study with a developed cataract. Conclusion Intravitreally applied triamcinolone acetonide has a moderate and temporary influence on the velocity of vitreal hemorrhage reabsorption, probably by the mechanism of sedimentation of triamcinolone’s crystals with blood elements. It can be a useful treatment option when vitrectomy in not possible.