Intravitreal Triamcinolone Injection with or Without Bevacizumab for Diabetic Macular Edema

Min Wook Chang; Seoung Woo Kim; In Kyung Oh; Jae Ryung Oh; Kuhl Huh

doi:10.3341/jkos.2008.49.8.1269

Journal List > J Korean Ophthalmol Soc > v.49(8) > 1008047

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Chang, Kim, Oh, Oh, and Huh: Intravitreal Triamcinolone Injection with or Without Bevacizumab for Diabetic Macular Edema

Original Article

J Korean Ophthalmol Soc 2008;49(8):1269-1274.

Published online: 7 September 2008

DOI: https://doi.org/10.3341/jkos.2008.49.8.1269

Intravitreal Triamcinolone Injection with or Without Bevacizumab for Diabetic Macular Edema

Min Wook Chang, M.D., Seoung Woo Kim, M.D., In Kyung Oh, M.D., Jae Ryung Oh, M.D., Kuhl Huh, M.D., Ph.D.

Department of Ophthalmology, Korea University College of Medicine, Seoul, Korea

Address reprint requests to Kuhl Huh, M.D., Ph.D. Department of Ophthalmology, Guro Hospital, Korea University College of Medicine #89, Guro-dong, Guro-gu, Seoul 152-703, Korea Tel: 82-2-2626-1260, Fax: 82-2-857l-8580, E-mail: dumky@unitel.co.kr

Received 6 May 2008 Accepted 26 December 2007

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To compare the effect of intravitreal triamcinolone injection with and without bevacizumab for diabetic macular edema.

Methods

Of 69 patients (69 eyes) diagnosed with diabetic macular edema without any history of other intraocular disease or intraocular operation, 45 eyes (45 patients) were injected with intravitreal triamcinolone (4 mg) and the remaining eyes (24 patients) were injected with triamcinolone (2 mg) and bevacizumab (1.25 mg). The visual acuity and central macular thickness of treated eyes from both groups was measured using OCT, and these measurements were compared between the two groups.

Results

There were no statistical differences between the two groups with respect to baseline data. Central macular thickness (CMT) was reduced in both groups, and BCVA improved in both groups. No significant differences were detected in changes in CMT or BCVA between the two groups.

Conclusions

Intravitreal injection of triamcinolone had a beneficial effect on DME in terms of CMT reduction and BCVA improvement. Addition of three consecutive intravitreal bevacizumab injections, however, did not show any significant addictive effect during the follow-up period.

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Keywords: BCVA, Bevacizumab, CMT, Triamcinolone

References

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Table 1.

A baseline comparison between 2 groups

	IVT*	IVT+IVB^†	P-value^‡
Age	56.88±12.14	57.12±11.04	0.935
Gender (M/F)	18/27	12/12	0.455
Past PRP Tx history			0.125
Yes	24	8
No	21	16
ME duration (month)	17.62±9.32	15.57±8.56	0.749
DM grade			0.220
Mild NPDR	0	0
Mod-severe NPDR	15	5
Very severe NPDR	6	8
PDR	17	9
High risk PDR	7	2
Type of DME			0.730
Diffuse	17	9
Cystoid	15	10
SRD	13	5

^* Intravitreal triamcinolone injection group;

^† Intravitreal triamcinolone and bevacizumab combination injection group; PRP=Pan retinal photocoagulation; ME=Macular edema; NPDR=Non proliferative diabetic retinopathy; PDR=Proliferative diabetic retinopathy; SRD=Serous retinal detachment.

^‡ independent t-test, chi-square test;

Table 2.

Mean (±SD) of changes in central macular thickness and best corrected visual acuity in relation to baseline

	Study group	Pre injection	1 month	2 months	3 months
CMT change (µm)	IVB	462.84±169.09	309.65±128.45	298.57±123.27	306.08±154.60
	IVB+IVT	532.64±132.58	325.43±130.13	320.06±117.63	358.67±58.19
	p-value	0.133	0.728	0.555	0.581
BCVA(logMAR)	IVB	0.93±0.51	0.78±0.49	0.81±0.44	0.69±0.44
	IVB+IVT	1.04±0.39	0.88±0.34	1.03±0.53	0.69±0.43
	p-value	0.464	0.435	0.261	0.997

CMT=Central Macular Thickness; BCVA=Best Corrected Visual Acuity; IVB=Intravitreal bevacizumab; IVT=Intravitreal triamcinolone.

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