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Laser photocoagulation versus combined laser photocoagulation and posterior sub-Tenon’s triamcinolone injection for the primary treatment of diffuse diabetic macular edema

Purpose: To evaluate the effectiveness of combined treatment with posterior sub-Tenon’s triamcinolone injection and focal laser photocoagulation, compared with laser treatment alone, in diffuse diabetic macular edema. Methods: This was a nonrandomized, prospective, controlled study that involved 20 eyes with diffuse diabetic macular edema. The patients were divided into 2 groups: group I (10 eyes) received focal laser photocoagulation alone; and group II (10 eyes) received combined focal laser photocoagulation and posterior sub-Tenon’s triamcinolone injection. All patients were followed for 6 months. Main outcome measures were final visual outcome and fluorescein leakage and retreatment rates at the end of the follow-up period. Results: Combined therapy showed better visual and angiographic outcome at 6 months. The retreatment rate was significantly lower in the combined-therapy group compared with the laser-therapy-alone group, with more stable visual acuity. Conclusion: Improvement of visual acuity and decreased fluorescein leakage suggest that combination therapy with posterior sub-Tenon’s triamcinolone injection and focal laser photocoagulation, particularly when used as a first-line therapy, is advantageous and merits further investigation.