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E. Kim, Y. Moon, H. Chin; Comparison of Results After Intravitreal Injection of Triamcinolone and Bevacizumab (Avastin) for Diabetic Macular Edema and Retinal Venous Occlusive Disease. Invest. Ophthalmol. Vis. Sci. 2008;49(13):3475. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
To compare the efficacy and outcomes after repeated intravitreal injection of triamcinolone (TA) and bevacizumab for macular edema in diabetic retinopathy and retinal vein occlusion (RVO).
This retrospective case series included 62 eyes of intravitreal bevacizumab injection and 81 eyes of intravitreal TA injection with macular edema in diabetic retinopathy and RVO. Patients were treated with a 0.1-mL injection containing 2.5 mg of bevacizumab or 4mg of TA. Patients treated with TA were reviewed for 12 months and patients treated with bevacizumab were reviewed for 6 months. This study compared 1) mean visual acuity (VA) at each follow up 2) change of final VA 3) mean time which attain peak VA 4) mean number of injection 5) mean injection interval 6) complications of injection between two groups. The change in foveal thickness was evaluated also.
In bevacizumab injection group, baseline mean VA ± SD was 0.49 ± 0.21 and 0.69 ± 0.29 logMAR of Snellen letters for DME and RVO, respectively. Mean VA ± SD increased to 0.21 ± 0.13 (DME) and 0.39 ± 0.13 (RVO) logMAR of Snellen letters after 2 months and 2 weeks, respectively with some regression to 0.50 ± 0.11 (DME) and 0.62 ± 0.34 (RVO) logMAR of Snellen letters after 6 months (P = 0.001).In TA injection group, baseline mean VA ± SD was 0.59 ± 0.23 (DME) and 0.67 ± 0.37 (RVO) logMAR of Snellen letters. Mean VA ± SD increased to 0.52 ± 0.25 (DME) and 0.45 ± 0.29 (RVO) logMAR of Snellen letters after 3 months and 1 month, with some regression to 0.61 ± 0.36 (DME) and 0.63 ± 0.45 (RVO) logMAR of Snellen letters after 6 months (P = 0.001).Mean foveal thickness by optical coherence tomography ± SD was 483 ± 155 µm (range, 234-1,028 µm) and decreased to 245 ± 180 µm at 4 weeks after injection (P = 0.001).In TA injection and bevacizumab injection, mean injection number was 1.2, 2.1 and mean interval was 4.6, 1.4 months, respectively. Mean time which attain peak visual acuity after injection was 1.1 (RVO), 2.8 (DME) months in TA injection and 1.2 (RVO), 1.1(DME) months in bevacizumab injection.
These results demonstrate that intravitreal injection of bevacizumab and TA can improve VA and reduce macular edema in diabetic retinopathy and RVO. However, the efficacy would be remained for about 3 months in both groups, with somewhat earlier effect in bevacizumab injection. These results will be helpful for determining number and time interval of intravitreal bevacizumab and TA injection. Prospective studies to confirm this observation should be considered.
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