Journal List > J Korean Ophthalmol Soc > v.55(8) > 1009746

Kim, Chung, Park, and Han: Comparison of Intravitreal Bevacizumab Alone Injection and Intravitreal Combination Low-Dose Bevacizumab-Triamcinolone Injection or Diabetic Macular Edema

Abstract

Purpose

To report the effects and intraocular pressure results of intravitreal bevacizumab alone injection compared with intravitreal low-dose bevacizumab combined with low-dose triamcinolone injection in patients with diabetic macular edema.

Methods

In total, 40 eyes of 40 patients diagnosed with diabetic macular edema were evaluated. Of these, 20 eyes of 20 patients were injected with intravitreal bevacizumab (1.25 mg/0.05 mL) and 20 eyes of 20 patients were injected with low-dose bevacizumab (0.625 mg/0.025 mL) combined with low-dose triamcinolone (1 mg/0.025 mL). The best corrected visual acuity (BCVA), central macular thickness, and intraocular pressure of treated eyes were measured before injection and at 1 month, 2 months, and 3 months after injection.

Results

In both the intravitreal bevacizumab and the low-dose bevacizumab combined with low-dose triamcinolone groups, BCVA increased significantly at 1 month, 2 months, and 3 months after injection (p< 0.05). In addition, in both groups, neither intraocular pressure (IOP) nor central macular thickness increased significantly at 1 month, 2 months, or 3 months after injection (p > 0.05). The BCVA, IOP, and central macular thickness (CMT) at 1 month, 2 months, and 3 months after injection showed no significant differences between the intravitreal bevacizumab group and the low-dose bevacizumab combined with low-dose triamcinolone group (p > 0.05).

Conclusions

The BCVA of both groups increased significantly, and the CMT of both groups decreased significantly in patients with diabetic macular edema. The injection of low-dose intravitreal bevacizumab combined with low-dose intravitreal triamcinolone may be useful for the treatment of diabetic macular edema.

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Figure 1.
Mean changes in best corrected visual acuity (BCVA) (log MAR) after injection. IVB = intravitreal bevacizumab injection; IVTA = intravitreal triamcinolone injection.
jkos-55-1155f1.tif
Figure 2.
Mean changes in intraocular pressure (IOP) (mm Hg) after injection. IVB = intravitreal bevacizumab injection; IVTA = intravitreal triamcinolone injection.
jkos-55-1155f2.tif
Figure 3.
Mean changes in central macular thickness (μm) after injection. CMT = central macular thickness; IVB = intravitreal bevacizumab injection; IVTA = intravitreal triamcinolone injection.
jkos-55-1155f3.tif
Table 1.
Characteristics of patients
Variable IVB (n = 20) IVB + IVTA (n = 20)
Age (years) 60.48 ± 8.25 62.82 ± 9.80
Sex
 Male 12 11
 Female 8 9
Lens
 Phakic 12 10
 Pseudophakic 8 10
Diabetic retinopathy
 NPDR 7 6
 PDR 13 14

Values are presented as mean ± SD.

IVB = intravitreal bevacizumab injection; IVTA = intravitreal triamcinolen injection; NPDR = non proliferative diabetic retinopathy; PDR = proliferative diabetic retinopathy.

Table 2.
Best corrected visual acuity (BCVA), IOP and central macular thickness before injection
IVB (n = 20) IVB + IVTA (n = 20) p-value
BCVA (log MAR) 0.78 ± 0.14 0.81 ± 0.22 0.852
IOP (mm Hg) 17.05 ± 0.25 16.53 ± 0.58 0.695
Central macular thickness (μm) 565.28 ± 80.65 612.53 ± 100.52 0.652

Values are presented as mean ± SD.

IOP = intraocular pressure; IVB = intravitreal bevacizumab injection; IVTA = intravitreal triamcinolone injection.

Table 3.
Mean changes in best corrected visual acuity (BCVA), IOP and central macular thickness after injection
Base line 1 month 2 months 3 months
IVB
BCVA (log MAR) 0.78 ± 0.14 0.59 ± 0.12 0.62 ± 0.08 0.67 ± 0.21
p-value 0.018 0.029 0.042
IOP (mm Hg) 17.05 ± 0.25 18.02 ± 0.38 18.58 ± 0.95 17.85 ± 0.85
p-value 0.525 0.625 0.453
CMT (μm) 565.28 ± 80.65 325.94 ± 110.35 351.20 ± 87.25 486.62 ± 50.25
p-value 0.011 0.027 0.039
IVB + IVTA
BCVA (log MAR) 0.81 ± 0.18 0.68 ± 0.08 0.72 ± 0.13 0.75 ± 0.18
p-value 0.025 0.052 0.253
IOP 16.53 ± 0.58 17.59 ± 0.59 18.28 ± 0.52 17.92 ± 0.82
p-value 0.538 0.632 0.423
CMT (μm) 612.53 ± 100.52 390.94 ± 98.35 423.50 ± 103.25 522.72 ± 80.27
p-value 0.022 0.039 0.042

Values are presented as mean ± SD.

IOP = intraocular pressure; CMT = central macular thickness; IVB = intravitreal bevacizumab injection; IVTA = intravitreal triamcinolone injection.

Table 4.
Mean changes in best corrected visual acuity (BCVA), IOP, central macular thickness (CMT) (?m) change after injection
1 month 2 months 3 months
BCVA (log MAR)
IVB 0.59 ± 0.12 0.62 ± 0.08 0.67 ± 0.21
IVB + IVTA 0.68 ± 0.08 0.72 ± 0.13 0.75 ± 0.18
p-value 0.525 0.193 0.685
IOP (mm Hg)
IVB 18.02 ± 0.38 18.58 ± 0.95 17.85 ± 0.85
IVB + IVTA 17.59 ± 0.59 18.28 ± 0.52 17.92 ± 0.82
p-value 0.125 0.693 0.385
CMT change (μm)
IVB 239.34 ± 50.95 214.18 ± 87.50 78.67 ± 10.15
IVB + IVTA 247.59 ± 40.55 189.23 ± 20.50 89.81 ± 50.12
p-value 0.564 0.281 0.326

Values are presented as mean ± SD; CMT change (μm): central macular thickness of base line - central macular thickness after intravitreal injection.

IOP = intraocular pressure; IVB = intravitreal bevacizumab injection; IVTA = intravitreal triamcinolone injection.

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