Background: Diabetic macular edema [DME] is a major factor contributing to the visual deterioration in most developed nations. OCTA helps visualization of diabetic microvascular changes such as microaneurysms, FAZ enlargement, and capillary non-perfusion areas.
Aim of the work: This study aims to assess the changes in the macular perfusion of diabetic patients before and after intravitreal triamcinolone acetonide injection compared to intravitreal ranibizumab injection by OCTA.  
Patients and methods: This comparative study included 40 eyes having DME scheduled at Al-Azhar university hospital, Damietta. Twenty eyes underwent intravitreal ranibizumab injection [Group I] and Twenty eyes underwent intravitreal triamcinolone acetonide injection [Group II].
Results: This study demonstrated that BCVA and CMT significantly improved in 1^st week up to 3 months in both groups. There was no statistically significant difference between the 2 groups as regards BCVA and CMT improvement [P value > 0.05]. As regards SCP [superficial capillary plexus], and DCP [Deep capillary plexus], there was some improvement in the macular perfusion of DCP in the ranibizumab group with no difference in macular perfusion of SCP in both groups and mild worsening of DCP in the triamcinolone group. The difference between the 2 groups was not significant statistically all over follow-up periods [P value > 0.05]. Also, the difference between the baseline macular perfusion and postoperative one in each group was not significant statistically [P value > 0.05].
Conclusion: Our study showed no significant changes in macular perfusion [SCP or DCP] following ranibizumab or triamcinolone injection in DME. In both groups.