Original scientific paper
Intravitreal Bevacizumab with or without Triamcinolone for Refractory Diabetic Macular Oedema
Svatopluk Synek
Petr Veselý
Abstract
We evaluate the effect of intravitreal injections of Bevacizumab (IVB) alone or combined with triamcinolone (IVT) in
the first injection for treatment of refractory diabetic macular oedema (DME). Sixty eyes of sixty patients with refractory
DME were included. Half of them received injections of IVB (1.25 mg/0.05 ml) or combined IVB and IVT (1.25 mg/0.05
ml and 2 mg/0.05 ml respectively). The primary outcome measure was change in central macular thickness (CMT). Secondary
outcome measures were change in best-corrected logMAR visual acuity (BCVA) and incidence of potential adverse
events. Central macular thickness was reduced significantly in both the IVB and IVB/IVT groups. At week 24, CMT
change compared to the baseline was –93.7 mm(95% CI, –172.2 to –19.26) in the IVB group and –93.1 mm(95% CI, –154.4
to –29.7) in the IVB/IVT group. There was not a significant difference between the IVB and the IVB/IVT groups. Improvement
of BCVA was initiated at weeks 6 and 12 in the IVB/IVT and IVB groups respectively. Anterior chamber reaction
was noticed in six (20%) and six (20%) eyes respectively in the IVB and IVB/IVT groups the day after injection, and it resolved
with no sequel. Elevation of intraocular pressure (IOP) occurred in two eyes (6%) in the IVB/ IVT group. Intravitreal
injections of Bevacizumab had a beneficial effect on refractory DME in terms of CMT reduction and BCVA improvement.
Addition of triamcinolone in the injection seemed to induce earlier visual improvement; however, it did not
show any significant additive effect later during follow-up.
Keywords
Bevacizumab; diabetic macular oedema; triamcinolone; intravitreal injection
Hrčak ID:
72183
URI
Publication date:
30.9.2011.
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