Materials and Methods: 73 eyes of 73 patients with refractory diffuse diabetic macular edema received an intravitreal injection of 4 mg triamcinolone acetonide. The outcome was evaluated by clinical examination and fluorescein angiography. The visual and anatomic changes and injection related complications were noted.

Results: The visual acuity improved significantly from the baseline level of 0.28±0.21 to a maximum of 0,407±0,25 at 10th day and reached to a maximum rate of patients with increased visual acuity at 20th day (90.27 %), after the injection. Mean increase in visual acuity was measured as 0.37, 0.407, 0.403, 0.39, 0.39 and 0.33 lines at the 3-10-20 days, 1- 3- 6 months follow-up intervals respectively. We observed a decreased fluorescein leakage on the angiograms. Three months after the injection, the macular edema increased and visual acuity showed a tendency to decline.Intraocular pressure exceeded 21 mm Hg in 10 eyes ,which could be controlled by topical medication,and 4 eyes exhibited cataract progression.No other complications were observed in our study during a mean follow-up of 5.9±1.12 (median:6) months.

Conclusion: Intravitreal injection of 4-mg TA seems to be effective in improving diffuse diabetic macular edema, at least in the short-term; however, it is necessary to repeat intravitreal injection every 4 to 6 months or to try a different therapy, due to macular edema recurrence and declining visual acuity. Keywords : Diffuse diabetic macular edema, intravitreal triamcinolone acetonide