Acta Biomedica Scientia

COMPARATIVE EFFICACY AND SAFETY OF INTRAVITREAL TRIAMCINOLONE ACETONIDE AND AUTOLOGOUS PLASMIN INJECTIONS IN THE MANAGEMENT OF DIFFUSE DIABETIC MACULAR EDEMA

Dr. Nischala Rama D

Diabetic macular edema (DME), Intravitreal Triamcinolone Acetonide (TA), Intravitreal Autologous Plasmin (IAP), Central Macular Thickness (CMT), Best-Corrected Visual Acuity (BCVA)

Diabetic macular edema (DME) is a leading cause of vision loss in diabetic retinopathy (DR). Intravitreal Triamcinolone Acetonide (TA) and Intravitreal Autologous Plasmin (IAP) injections have been studied for their efficacy in reducing DME and improving visual acuity. This study compares the effectiveness of TA and IAP in managing diffuse diabetic macular edema (DDME). Methods: A total of 160 patients diagnosed with bilateral DDME were enrolled in a randomized clinical study Patients were divided into two groups: one receiving intravitreal TA injections (4 mg/0.1 mL) and the other intravitreal IAP injections. Central macular thickness (CMT), best-corrected visual acuity (BCVA), and intraocular pressure (IOP) were recorded at baseline, 1 month, 3 months, and 6 months post-injection. Statistical analysis was conducted using the Wilcoxon rank-sum test, with significance set at p ? 0.05. Results: Both TA and IAP significantly reduced CMT and improved BCVA at 1 month post-injection. However, at 6 months, IAP demonstrated a more stable reduction in CMT (318.7 ± 56.3 µm) compared to TA (335.2 ± 57.9 µm, p < 0.05). Visual acuity improvement was sustained in the IAP group (0.340 ± 0.118 logMAR) compared to the TA group (0.380 ± 0.096 log MAR, p < 0.05). The TA group exhibited a persistent increase in IOP, reaching 18.7 ± 2.8 mmHg at 1 month and remaining elevated at 17.6 ± 2.9 mmHg at 6 months, whereas IAP maintained a stable IOP (16.4 ± 3.0 mmHg at 6 months, p < 0.05). Conclusion: Both treatments were effective in reducing DME, but IAP demonstrated a longer-lasting therapeutic effect with fewer side effects on intraocular pressure. The results suggest that IAP may be a safer and more stable alternative to TA for the management of DDME. Further long-term studies are required to validate the efficacy and safety of IAP injections as a potential first-line therapy for DME