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M. Frey, M. S. TÖnz, C. K. Brinkmann, U. E. K. Wolf-Schurrbusch, S. Wolf; Comparison of Short-Term Effects After Intravitreal Application of Triamcinolone and Avastin® (bevacizumab) in Patients With Diabetic Macular Edema. Invest. Ophthalmol. Vis. Sci. 2008;49(13):3512.
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We report on the comparison of the short term effects after intravitreal injection of Triamcinolone and Avastin® (Bevacizumab) in patients with clinically significant macular edema (CSME) due to Diabetes mellitus (DM).
In this study 30 patients with CSME due to DM underwent intravitreal treatment. 15 eyes of 15 patients received Triamcinolone while the other 15 patients were treated with Bevacizumab. Patients underwent a complete ophthalmologic examination including ETDRS visual acuity (VA), OCT, color fundus photography and fluorescein angiography at baseline and follow-up examinations at 24, 72 and 168 hours (h).
In the Triamcinolone group VA increased by 4 ± 13 letters (L) after 24 h, by 6 ± 11 L after 72 h, and by 8 ± 12 L after 168 h.Mean central foveal thickness (CFT) was 464 ± 157 µm at baseline, 354 ± 133 µm at 24 h, 330 ± 90 µm at 72 h and finally 295 ± 82 C at 168 h.In the Avastin® group VA increased by 2 ± 6 L after 24 h.by 7 ± 5 L after 72 h group, and with statistical significance by 6 ± 4.6 L after 168 h.CFT was 407 ± 72 µm at Baseline, 398 ± 58 µm at 24 h, 375 ± 67 µm at 72 h and 364 ± 64 µm at 168h.In the Triamcinolone group statistical significance was found after 72 h in VA and after 24 h for the reduction in retinal thickness.In the Avastin® group the reduction of about 10% in retinal thickness from BL to the 168 h follow-up was not statistically significant (p = 0.058). Statistical significance for VA was found after 168h (BL: 64 ± 11 L vs 168 h: 68.5 ± 9.2 L; p < 0.05).
Triamcinolone leads to a statistically significant decrease of retinal thickness compared to Avastin® in patients with CSME due to DM. Both treatments result in statistically significant improvement in VA within days. The decrease in retinal thickness in the Triamcinolone group precedes the improvement in visual acuity and may contribute to it. In Avastin® group, the gain in VA precedes measurable changes in central retina. Slight changes in the central retina may contribute to the fast increase of vision.
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