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M. Maia, F. M. Penha, L. Wu, J. F. Arevalo, J. A. Cardillo, M. E. Farah, F. J. Rodriguez, M. H. Berrocal, W. C. Furtado, Pan-American Collaborative Retina Study Group (PACORES); Comparison of a Single Intravitreal Injection of Bevacizumab versus Triamcinolone Acetonide as Primary Treatment for Diffuse Diabetic Macular Edema: The Pan-American Collaborative Retina Study Group (PACORES). Invest. Ophthalmol. Vis. Sci. 2010;51(13):4225.
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To compare the functional and anatomic outcomes of a single intravitreal injection of triamcinolone acetonide (IVT) versus a single intravitreal injection of bevacizumab (IVB) as primary treatment for diffuse diabetic macular edema (DDME).
Retrospective multicenter interventional comparative case series. We reviewed the clinical records of 158 consecutive eyes with previously untreated DDME that were managed with a single intravitreal injection of 1.25 mg or 2.5 mg of IVB (77 eyes) or 4 mg of IVT (81 eyes). Patients were evaluated at 1, 3 and 6 months after the injection. The main outcome measures were central macular thickness (CMT) and Early Treatment Diabetic Retinopathy Study (ETDRS) best-corrected visual acuity (BCVA).
Both groups had a statistically significant improvement on BCVA and CMT from baseline at each follow-up time period (p < 0.001). However, when the mean BVCA improvement from baseline was compared between groups, this difference was not statistically significant. There was a mean of 3 lines improvement in BCVA in the IVB group versus a mean of 4 lines improvement in the IVT group (p = 0.39). CMT analysis demonstrated that the IVT group had a more significant decrease at each follow up time point (1, 3 and 6 months): 179.83 µm, 168.84 µm and 99.26 µm versus 113.48 µm, 66.32 µm and 39.12 µm in the IVB group, (p < 0.001).
This short-term study suggests that both IVT (4 mg) and IVB (1.25 or 2.5 mg) may improve BCVA and CMT as primary treatment for DDME. However, a single injection of IVT seems to be more effective than IVB to reduce CMT for up to six months.
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