Efficacy and clinical outcomes of suprachoroidal triamcinolone acetonide in diabetic macular edema patients: a single-arm systematic review and meta-analysis.

This systematic review and meta-analysis aims to evaluate the efficacy of suprachoroidal triamcinolone acetonide (SCTA) in patients with diabetic macular edema (DME). The study was conducted following PRISMA guidelines, involving a comprehensive search of electronic databases was performed to identify relevant studies assessing SCTA in DME, and data from selected studies were pooled for analysis. The primary outcomes were changes in central macular thickness (CMT) and corrected distance visual acuity (CDVA). Secondary outcome was the duration of therapeutic effect, intraocular pressure (IOP) and other complications. The random-effects model was used to calculate the pooled mean with 95% confidence intervals (CIs). Eleven studies were included, comprising a total sample size of 411 eyes. In patients with DME receiving SCTA, CMT significantly improved over the study period (SMD: -5.377, 95% CI: -7.290 to -3.464, P = 0.000), decreasing from a pooled mean of 545.313 μm at baseline to 315.794 μm at last follow-up post-injection. CDVA improved from a baseline value of 0.777 to 0.521 LogMAR at final follow-up but failed to demonstrate statistical significance (SMD: 1.083, 95% CI: -0.520 to 2.686, P = 0.185). Additionally, the therapeutic effect of SCTA was shown to last up to 6 to 12 months in several studies. Post-injection IOP remained stable (SMD: 0.428, 95% CI: -0.324 to 1.179, P = 0.264). Other complications included cataract progression, particularly in phakic patients, while retinal detachment and endophthalmitis were rare. In conclusion, SCTA intervention in DME patients demonstrated a significant improvement in CMT along with stable CDVA and IOP. The absence of IOP elevation is a key advantage, making SCTA an effective and safe treatment option with favorable structural and visual outcomes.