PURPOSE: To assess the effect of triamcinolone acetonide over 3 months on hard exudates in patients with diabetic macular oedema (DMO). METHODS: Thirty-two eyes of 16 patients with DMO and hard exudates were included in a randomized, placebo-controlled trial. Treated eyes received a single-dose (4 mg) intravitreal injection of triamcinolone acetonide. Control eyes received an injection of subconjunctival saline. RESULTS: The overall area of hard exudates decreased significantly between the baseline and 3-month visits in treated eyes, but not in control eyes. The mean change in level of hard exudates between the two visits was -0.75 arbitrary units (AU) (95% confidence interval [CI] -1.32 to -0.18) in the central plus inner circle (1500 microm) and -0.81 AU (95% CI -1.49 to -0.13) over the whole grid (3000 microm) in treated eyes, compared with 0.31 AU (95% CI -0.19 to 0.82) and 0.31 AU (95% CI -0.11 to 0.74), respectively, in control eyes (p < 0.001). Mean visual acuity improved by five letters in treated but not in control eyes (p = 0.01). CONCLUSIONS: Intravitreal triamcinolone reduces hard exudates in the short-term in eyes with DMO.