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Olivia Baldivieso Hurtado, Romina Baldivieso Hurtado, Valeria Baldivieso Hurtado, Daniel Ochoa Contreras; Comparison Of Intravitreal Ranibizumab Alone Or Combined With Triamcinolone Versus Macular Photocoagulation For Treatment Of Diabetic Macular Edema. Invest. Ophthalmol. Vis. Sci. 2012;53(14):397.
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Ranibizumab as well as intravitreal triamcinolone acetonide have shown a beneficial effect in reducing Diabetic Macular Edema (DME) and improving Visual Acuity (VA), however, they have been studied separately in several studies and there is no report that combines their intravitreal effect. The aim of this study is to assess the effectiveness and safety of combining ranibizumab (Lucentis ™) with triamcinolone acetonide (Kenalog ™) for the treatment of DME.
We performed a prospective, comparative, randomized controlled clinical trial from January to September 2011. Eighty eyes were included, diagnosed with DME, assigned into: Group A (32 eyes): treated with 0.5mg intravitreal injection (IVI) of ranibizumab, Group B (20 eyes): treated with 0.5 mg IVI of ranibizumab combined with 2 mg triamcinolone acetonide, Group C (28 eyes): treated with macular laser photocoagulation. All patients were assessed with slit lamp biomicroscopy, best corrected visual acuity (BCVA) and Optic Coherence Tomography (OCT), pre-intervention and at 1, 30 and 60 days after the procedure. The primary outcome measures were BCVA, central macular thickness (CMT) changes and incidence of potential adverse events.
BCVA at 30 and 60 days of treatment improved significantly in group B, group A had a slight improvement, and group C worsened. The greatest reduction in microns of the OCT at 30 days of treatment was achieved by group B, but after 60 days by group C.
The results of our study shows that patients with DME treated with the combination of ranibizumab and triamcinolone acetonide obtained better visual outcomes at 30 and 60 days, and greater reduction of the central macular thickness at 30 days of treatment.
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