Effectiveness of Suprachoroidal Triamcinolone Acetonide at Reducing Central Subfield Thickness in Diabetic Macular Edema, A Descriptive Case Series

Background: Injection of corticosteroids into suprachoroidal space enables therapeutic drug levels to be attained in retina and choroid while minimizing them in anterior chamber. This helps deliver a higher drug concentration in posterior chamber whilst minimizing the potential side effects of conventional intravitreal steroid therapy, like cataract formation and increased intraocular pressure. Objectives: To assess effectiveness of Suprachoroidal Triamcinolone Acetonide (SCTA) injection at reducing central subfield thickness in individuals suffering from diabetic macular edema (DME). Methods: A Descriptive case series study was carried out at Department of Ophthalmology, Lahore General Hospital, Lahore from 1st July 2021 to 31st December 2021. A total of 150 treatment naive patients with DME, age range from 18-70 years and any gender, were selected. We excluded those patients that had history of uveitis, intraocular surgery, cataract, macular ischemia, and ocular hypertension or those with macular edema secondary to any other pathology. They were observed for three months after getting a SCAT injection. They were examined at one week, one month and third month. At the end of three months, the outcome measure was a change in central subfield thickness (CST) from the baseline. Results: The patients in our study had age ranging from 18 to 70 years with a mean of 51.10 ± 9.53 years. Most of the patients 114 (76.0%) had ages between 46 to 70 years. Out of these 150 individuals, 77 (51.33%) were males and 73 (48.67%) were females. Mean pre-injection CST was 299.76 ± 13.72µm and after 3 months, it reduced to 250.49 ± 17.82 µm. Using paired t-test, the difference was found to be statistically significant with a p-value of 0.0001. Conclusion: Our study concludes that SCTA injection is clinically and statistically effective at reducing central subfield thickness in treatment naive patients with DME, with no adverse consequences. Further studies assessing BCVA, with longer follow-up can potentiate the observation at hand.