Intravitreal injection of triamcinolone acetonide versus bevacizumab for diabetic macular edema

Abstract

Objective To compare the clinical efficacy of intravitreal triamcinolone acetonide (TA)and intravitreal bevacizumab for diabetic macular edema (DME). Methods In a total of 68 cases (82 eyes)with DME who underwent routine ocular examination and optic coherence tomography were enrolled in this study. The patients were divided into two groups for intravitreal TA (4mg, 0.1ml) or intravitreal bevacizumab (1.25mg, 0.05ml) injection. The difference of age, diabetes duration, macular edema duration, best corrected visual acuity (BCVA), central macular thickness (CMT) and intraocular pressure between TA group (37 cases, 45eyes) and bevacizumab group (31 cases, 37 eyes) were insignificant. The change ofBCVA, CMT and intraocular pressure at 4-week, 8-week and 12-week follow-up between the two groups were compared. Results At the 4-week, 8-week and 12-week follow-up, the change of BCVA between TA group and bevacizumab group did not vary significantly (t =-0.316, 0.896, and 0.879; P =0.754, 0.389 and 0.384, respectively). At 4-week and 12-week follow-up, the reduction of macular edema in TA group was significantly higher than bevacizumab group (t =-1.892 and -3.007; P =0.036 and 0.004, respectively). At the 8-week follow-up, the reduction of macular edema between two groups were insignificant (t =-0.362; P =0.722). At the 8-week and 12-week follow-ups, intraocular pressure in TA group were significantly higher than bevacizumab group (t =2.334 and 2.600; P =0.026 and 0.015, respectively). Conclusions Intravitreal injection of triamcinolone acetonide is more effective than intravitreal injection of bevacizumab in reducing the thickness of macular edema. Moreover, the efficacy ofintravitreal TA last for a longer time than bevacizumab. Randomized, control and multicenter study with large scale patients is needed. Key words: Triamcinolone Acetonide; Bevacizumab; Diabetic retinopathy; Macular edema