Secondary Logo

Journal Logo

Institutional members access full text with Ovid®

COMPARISON OF INTRAVITREAL TRIAMCINOLONE ACETONIDE VERSUS INTRAVITREAL BEVACIZUMAB AS THE PRIMARY TREATMENT OF CLINICALLY SIGNIFICANT MACULAR EDEMA

Liu, Qingyun MD*; Hu, Yijun MD†,‡; Yu, Honghua MD§; Yuan, Ling MD, PhD; Hu, Jie MD, PhD; Atik, Alp MD, MPH; Guan, Meng MMed; Li, Dongli MMed; Li, Xin MB**; Tang, Shibo MD, PhD††

doi: 10.1097/IAE.0000000000000300
Original Study
Buy

Objectives: To evaluate the short-term efficacy of triamcinolone acetonide versus bevacizumab for the treatment of diabetic, clinically significant, macular edema with different optical coherence tomography findings.

Methods: Fifty eyes of 45 consecutive patients with diabetic, clinically significant, macular edema were incorporated in this prospective interventional case series. Patients were divided into 3 groups according to findings on optical coherence tomography: 1) macular edema combined with serous retinal detachment (Group 1), 2) diffused macular thickening (Group 2), and 3) cystoid macular edema (Group 3). Patients from each group were treated with a single intravitreal injection of triamcinolone (IVTA) or 2 intravitreal injections of bevacizumab (IVB) with an interval of 6 weeks. Patients were observed at 6, 12, and 24 weeks after IVTA or the first IVB injection. Best-corrected visual acuity (BCVA) and central retinal thickness (CRT) were examined at each visit. Repeated-measures analysis of variance was used to compare the efficacy of the treatment groups.

Results: In Group 1, IVTA showed more favorable effects on CRT reduction and BCVA improvement compared with IVB at 6, 12, and 24 weeks (P = 0.002, 0.001, 0.027 and P = 0.036, 0.001, 0.027), respectively. In Group 2, IVB had more CRT reduction than IVTA at 6 and 12 weeks (P = 0.013 and 0.036), although there was no significant difference in BCVA improvement between the 2 groups (P > 0.05). In Group 3, IVTA and IVB did not have significant effects on CRT reduction and BCVA improvement (P > 0.05).

Conclusion: The short-term efficacy of IVTA and IVB on treating clinically significant macular edema varied with different optical coherence tomography findings. In clinically significant macular edema combined with serous retinal detachment, IVTA may be more favorable than IVB in CRT reduction and BCVA improvement. In patients with diffused macular thickening, IVB may be better than IVTA in macular thickness reduction, although this does not translate to a significant improvement in BCVA.

The authors investigated the short-term efficacy of triamcinolone acetonide versus bevacizumab for the treatment of clinically significant macular edema stratified according to optical coherence tomography findings. Triamcinolone acetonide may be more favorable than bevacizumab in central retinal thickness reduction and visual acuity improvement in clinically significant macular edema combined with serous retinal detachment.

*Department of Ophthalmology, Tongliao City Hospital, Tongliao, China;

State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China;

Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts;

§Department of Ophthalmology, General Hospital of Guangzhou Military Command of PLA, Guangzhou, China;

Department of Ophthalmology, The First Affiliated Hospital of Kunming Medical University, Kunming, China;

**Kunming Medical University, Kunming, China; and

††Aier School of Ophthalmology, Central South University, Changsha, China.

Reprint requests: Shibo Tang, MD, PhD, Aier School of Ophthalmology, Central South University, Fourth Floor, New Century Mansion, 198 Middle Furong Road, Changsha 410015, China; email: tangshibo@vip.163.com

Supported by grant 81260151 from the National Natural Science Foundation of China (L. Yuan), grant 2011FB062 from the Applied Basic Research Foundation of the Department of Science and Technology of Yunnan Province (L. Yuan), and grant 2011WS0041 from the Science and Technology Foundation of the Department of Health of Yunnan Province (L. Yuan).

Q. Liu, Y. Hu, and H. Yu have contributed equally to this study and should be considered as co-first authors. Shibo Tang and Ling Yuan (email: yuanling8061@163.com) should be considered as co-corresponding authors.

None of the authors have any conflicting interests to disclose.

© 2015 by Ophthalmic Communications Society, Inc.