To evaluate posterior sub-Tenon injection of triamcinolone acetonide (TA) for recurrent diabetic macular edema (DME) after repeated intravitreal bevacizumab (IVB).

This is a retrospective interventional case series comprised of 35 eyes (32 patients) with recurrent clinically significant DME after two or more IVB treatments. All patients were administered TA 40 mg injections. Best-corrected visual acuity (BCVA), central macular thickness (CMT), and intraocular pressure (IOP) were reevaluated at months 1, 3, and 6.

The baseline OCT showed five eyes with diffuse retinal thickening, 18 eyes with cystoid macular edema, and 12 eyes with serous retinal detachment. Mean BCVA improved at months 1 and 3, and mean CMT decreased at months 1 and 3. However, mean BCVA and CMT at six months was not different from baseline. Each DME pattern showed significant improvements in BCVA and CMT at three months. Mean IOP at months 1, 3, and 6 did not show any significant difference from baseline. No eyes showed complications including cataract progression or endophthalmitis.

Posterior sub-Tenon injection of TA should be considered for patients with recurrent DME after repeated IVB. The studied eyes showed improvements in BCVA and CMT during three months in all of the three patterns of DME.