Comparison of Suprachoroidal Triamcinolone Injection and Modified Grid Laser in Treatment of Refractory Diabetic Macular Edema

Diabetic macular edema is the leading cause of blindness in diabetic eye disease. The most important cause of visual impairment is diabetes-induced macular edema also called DME which involves central part of the macula lutea. Objective: To compare the outcome of suprachoroidal triamcinolone injection and modified grid laser in the treatment of refractory diabetic macular edema. Methods: This prospective cohort study was done for 12 months (January 2021 to December 2021) on 56 patients having refractory diabetic macular edema. The technique of non-probability consecutive sampling was used. Patients in Group A received a suprachoroidal injection of 4 mg triamcinolone. Patients in Group B underwent modified grid photocoagulation. After 4 months of treatment, the patients' visual acuity and central macular thickness were assessed again using Snellen's chart and Optical Coherence Tomography (OCT) respectively. Results: After 4 months, the mean BCVA in Group-A was 0.57 + 0.127 and in Group-B was 0.83 + 0.150 (P=0.000) while the mean improvement (change line) was 1.6 + 0.318 and 0.89 + 0.229 (P=0.001), respectively In Group-A, improvement in Central Macular Thickness (CMT) was observed in 24 (85.7%) patients, while in Group-B, improvement in Central Macular Thickness was seen in 17 (60.7%) patients. After 4 months, the mean CMT in Group-A was 302.68 + 14.427 um and in Group-B was 339.71 + 54.821 um (P=0.009) while the mean improvement (change) was 153.89 + 30.902 um and 95.57 + 41.111 um (P=0.024), respectively. Conclusion: Suprachoroidal triamcinolone injection was found to be more effective than modified grid laser in treatment of DME.