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M. J. Koss, F. Al-Sarireh, A. Sener, S. Scholtz, P. Singh, F. H. Koch; Triple Therapy in Diabetic Retinopathy. Invest. Ophthalmol. Vis. Sci. 2008;49(13):3472.
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To report the effect of a triple therapy (TT= core pars plana vitrectomy (cppV), intravitreal injection of triamcinolone and bevacizumab) in diabetic retinopathy (DR).
The retrospective case-series involved 69 patients with diabetes (Typ I+II), mean age64.4 , distributed in group I(n=24)-DR and ischemic maculopathy; group II(n=31)-non proliferative DR; group III(n=14)-proliferative DR, both without ischemic maculopathy. All groups received a 23 gauge cppV (sutureless, single sclerotomy) with aspiration of 0.5ml vitreous and substitution with 8mg triamcinolone and 1.25 mg bevacizumab through two different openings in one probe tip. Main outcome measures included BCVA (5m Snellen), IOP, OCT and fluorescein angiography. Mean f/u was at 11, 24 and 42 weeks.
At baseline, mean BCVA was 0.19 (group I), 0.35 (group II) and 0.27 (group III); which increased at 24 weeks to 0.24(group I), 0.48 (group II) and 0.28 (group III). IOP elevation was noticed in 6/76 cases(7,9%) and controlled by eyedrops.Central macular thickness decreased in 72/76 cases (94.7%). TT was continued in 17/76 patients (22.4%), besides one complete ppV in group II. In group III laserphotocoagulation attributed TT in 7/76 cases(9.2%) .
These prelimary results indicate, that TT may be an effective treatment due to the drugs and to the additional effect of the redistribution of intraocular oxygen induced by the core vitrectomy, which favorably was observed in patients with non-proliferative diabetic retinopathy without ischemic maculopathy.
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