Quantitative evaluation of reduction of plaque-like hard exudates in diabetic macular edema after intravitreal triamcinolone injection

Background To describe a new method of quantifying the amount of plaque-like hard exudates after intravitreal triamcinolone acetonide injection in diabetic macular edema. Methods This study included 22 eyes of 14 patients (mean age, 63 years) with chronic diabetic macular edema and plaque-like hard exudates. The patients were injected with a single dose of 4 mg intravitreal triamcinolone acetonide. The optic disc size as relative size unit was taken to quantify the hard exudates: Total areas of exudates and the optic nerve head were computed from fundus pictures with a digital analysis program on magnified images. The former was divided by the latter, and the results were expressed as a percentage value. The ratio was used to track improvements in a given eye over 6 months. Results Average ratio of hard exudates to optic nerve head area reduced to 81% of its initial value at 1 month (P = 0.007), to 54% at 3 months (P < 0.001) and to 41% at 6 months (P < 0.001). Conclusions The new method allowed detection of a significant reduction of ratio of hard exudates to optic disc area of diabetic plaque-like hard exudates following 4 mg intravitreal triamcinolone.