The Ophthalmology Unit,  Universiti Malaysia Sarawak (UNIMAS), Kuching, Sarawak.

The Ophthalmology Department, Sarawak General Hospital, Kuching, Sarawak, East Malaysia.

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Intravitreal triamcelone for diabetic maculopathy

Photo by Dr. Mahadhir Alhady

 

A 63 year-old woman with poorly controlled diabetes mellitus presented with two-year history of progressive worsening left vision. Fundoscopy revealed hard exudates in the fovea and clinically significant macular oedema. Despite repeated focal laser, the oedema failed to resolve and the vision was hand movement. After discussing with the patient, she agreed to intravitreal triamcelone. A 0.1 ml(4mg) dose was given via the inferior approach to avoid significant clouding the vision from the triamcelone crystals. There was a significant reduction of macular oedema within 48 hours but the vision was reduced by the triamcelone crystals. At the last clinical visit, the macular oedema resolved but the vision remained poor most likely due to the presence of hard exudates in the fovea.

 

Severe diabetic maculopathy.

 

An inferior  cloud of triamcelone crystals 24 hours post-intravitreal injection.

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