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M. S. Folgosa, R. A. Costa, D. R. Lucena, I. U. Scott, R. Jorge; Intravitreal Triamcinolone Plus Bevacizumab for Treatment of Refractory Diabetic Macular Edema. Invest. Ophthalmol. Vis. Sci. 2008;49(13):3515.
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To report the short-term morphologic and visual acuity outcomes in a series of patients with refractory diffuse diabetic macular edema (DME) treated with one intravitreal injection of bevacizumab and one intravitreal injection of triamcinolone acetonide (both injections administered at the same sitting).
Eight consecutive patients with DME unresponsive to macular laser grid photocoagulation (refractory diabetic macular edema) were assigned to receive an intravitreal injection of 1.25 mg/0.05ml of bevacizumab and an intravitreal injection of 2 mg/0.05ml of triamcinolone acetonide (both injections administered at the same sitting). Comprehensive ophthalmic evaluation was performed at baseline and at 1, 4, 8±1, and 12±2 weeks after treatment. Main outcome measures included central macular thickness measured with optical coherence tomography (OCT) and logMAR best-corrected visual acuity (BCVA).
Eight patients (8 eyes) completed the 12-week study period. The mean baseline central subfield thickness was 413.25 µm and the mean baseline logMAR BCVA was 0.715. A significant change from baseline in mean central subfield thickness (µm) was observed at week 1 (-69.38), week 4 (-123.38), and week 8 (-78.13) (p<0.05). A significant change from baseline in mean logMAR BCVA was observed at weeks 4 (-0.168) and 8 (-0.20) (p<0.05). There was no significant change from baseline in mean intraocular pressure (mmHg) at any study visit. No patient had observed cataract progression during the study.
These results demonstrate that intravitreal injection of triamcinolone plus bevacizumab is associated with short-term improvements in central subfield thickness and visual acuity in eyes with refractory diffuse diabetic macular edema. Further studies are warranted to investigate longer-term outcomes in a larger series of eyes.
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