Abstract: India, the epicenter of diabetes, faces a daunting projection of 100 million diabetic individuals by 2030. Burden of diabetic macular edema (DME) as a part of diabetic retinopathy is significant and continues to impose substantial challenges in management vis a vis protocols and treatment affordability. In developing nations, the utilization of multiple intravitreal anti-VEGF and steroids injections as a primary therapeutic modality is impeded by financial constraints. To address these issues, we proposed a novel technique with a drug which not only mitigates cost constraints but is also efficacious in the management of DME. Using easily available material like 22G and 26G needles, this makeshift apparatus can be used for targeted delivery of triamcinolone acetonide (TA) in the suprachoroidal space. Applying this technique on 4 patients, we noted resolution of edema on post-injection OCT with concurrent improvement in visual acuity, which further culminated in a prospective study comparing suprachoroidal TA versus intravitreal dexamethasone with 25 patients each.
Sharma et al. (Sat,) studied this question.