Intravitreal Triamcinolone Acetonide and Bevacizumab versus Intravitreal Bevacizumab and Posterior Subtenon Triamcinolone Acetonide in Refractory Diabetic Macular Edema.
- Resource Type
- Article
- Authors
- Gul, Ambreen; Niazi, Fuad Ahmad Khan; Raza, Ali
- Source
- Pakistan Journal of Ophthalmology. 2022, Vol. 38 Issue 3, p186-192. 7p.
- Subject
- *TRIAMCINOLONE acetonide
*ACETONIDES
*BEVACIZUMAB
*MACULAR edema
*OPTICAL coherence tomography
- Language
- ISSN
- 0886-3067
Purpose: To compare the effects of combined simultaneous injection of intravitreal triamcinolone acetonide and bevacizumab with intravitreal bevacizumab and posterior subtenon triamcinolone acetonide in treatment of refractory diabetic macular edema. Study Design: Quasi experimental study. Place and Duration of Study: Rawalpindi Medical University from January 2019 to December 2019. Methods: Forty pseudophakic diabetic patients with refractory diabetic macular edema with central retinal thickness (CRT) of > 350 μm on OCT were included in the study. Group A was given simultaneous injection of intravitreal bevacizumab 1.25 mg/0.05 ml with posterior sub-tenon triamcinolone 40mg while group B had intravitreal bevacizumab with simultaneous intravitreal triamcinolone 2 mg/0.05 ml. Changes in the BCVA, IOP and CRT were evaluated in both groups. Results: Group B showed a more significant decrease in the median CRT at 1 month (p = 0.0002). After 3 months, the reduction in CRT was not statistically different between the two groups (p > 0.05). Both groups had significant improvement in BCVA compared to pre-injection baseline visual acuity. Five eyes in group B and none in group A developed IOP beyond 22 mmHg. At 12 weeks, 7 patients of group A and 6 of group B developed recurrent macular edema and required repeated injections. Conclusion: Posterior subtenon triamcinolone is as effective as intravitreal triamcinolone in conjunction with intravitreal bevacizumab in reducing CRT and improving and stabilizing BCVA. Posterior subtenon injection is safer as compared to intravitreal injection in terms of rise of IOP. [ABSTRACT FROM AUTHOR]