Intravitreal bevacizumab versus bevacizumab and 1 mg triamcinolone acetonide in eyes with bilateral diabetic macular edema

Abstract

AIM: To compare of intravitreal bevacizumab and intravitreal bevacizumab and triamcinolone acetonide in eyes with bilateral diabetic macular edema. METHODS: In this retrospective comparative-randomized study, 42 eyes of 21 diabetic patients with bilateral macular edema were evaluated. In one eye intravitreal injection of 1.25 mg bevacizumab (IVB group) was performed and in the fellow eye intravitreal injection of combined 1.25 mg bevacizumab and 1 mg triamcinolone acetonide (IVTA-IVB group) was performed. Main outcomes were the central macular thickness (CMT) measured with optical coherence tomography (OCT), ETDRS visual acuity (VA) and intraocular pressure (IOP). RESULTS: Mean follow-up time was 4.7±1.5mo. In the IVB and IVTA-IVB groups, mean CMT was 494.7±114.4 ?m and 546.8±165.6 ?m before injections; 430.4±133.2 ?m and 363.7±105.3 ?m in first month; 484.8±167.4 ?m and 407.3±108.7 ?m in 3rd month; 550.4±191.5 ?m and 516.8±158 ?m after 6mo respectively. Differences were significant in first and 3rd months (P<0.05). In the IVB and IVTA-IVB groups, mean ETDRS VA score was 57.1±13.5 and 48.9±13.9 before injections; 62.2±14 and 58.8±12.1 in first month; 59±13.7 and 59.3±13.6 in 3rd month; 55.6±14.9 and 55.5±8.7 after 6mo respectively. Differences were significant in first and 3rd and 6mo (P<0.05). There was no IOP difference. IVTA-IVB group gains best VA in 3rd month after the first injection and maintains it for 6mo whereas IVB group gains best VA at first month and can be able to maintain for 3mo. CONCLUSION: Injection of 1 mg IVTA-IVB seems to be better than IVB alone in improving VA for 6mo without any steroid dependent complications. Copyright 2019 by the IJO Press.