Efficacy of posterior sub-Tenon’s capsule injection compared to intravitreal injection of triamcinolone acetonide for treatment of diabetic macular edema: A systematic review and meta-analysis

Abstract

DME is defined as a retinal thickening in one DD of the centre of the macula. It is a number of microvascular retinal changes that lead to BRB disruption, causing leakage of fluid and plasma components into the inner and outer plexiform layers. DME is a major complication of DR and a main cause of loss of vision in diabetic patients. TA is a long-acting steroid used for the treatment of DME, whether by intravitreal or posterior sub-Tenon capsule injection. The current study was performed to compare the two injection routes IVTA and STTA in terms of their efficacy and resulting complications such as IOP elevation, cataract formation, endophthalmitis, VH, and RD after the injection. This meta-analysis included ten studies that were published between 2000 and 2019. They were RCTs, and about 343 patients with DME (469 eyes) participated in these studies. The mean age ranged between 54.125 and 64.7 years. The baseline of the mean BCVA ranged between 1.077 and 0.6 log.MAR and the baseline of the CMT was between 308.80 and 525.1 μm, while the baseline of the mean IOP was between 13 and 16.46 mmHg.