July 2018
Volume 59, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2018
The DiMECat Trial: A Prospective, Randomised Clinical Trial Of Intravitreous Bevacizumab vs. Triamcinolone In Patients With Diabetic Macular Oedema At The Time Of Cataract Surgery – 6 Month Results
Author Affiliations & Notes
  • Lyndell L Lim
    Centre for Eye Research Australia, University of Melbourne, East Melbourne, Victoria, Australia
    Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia
  • Marios Constantinou
    Centre for Eye Research Australia, University of Melbourne, East Melbourne, Victoria, Australia
  • Sophie Rogers
    Centre for Eye Research Australia, University of Melbourne, East Melbourne, Victoria, Australia
  • Sukhpal Singh Sandhu
    Centre for Eye Research Australia, University of Melbourne, East Melbourne, Victoria, Australia
    Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia
  • Sanjeewa Wickremasinghe
    Centre for Eye Research Australia, University of Melbourne, East Melbourne, Victoria, Australia
    Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia
  • Salmaan Al-Qureshi
    Centre for Eye Research Australia, University of Melbourne, East Melbourne, Victoria, Australia
    Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia
  • Footnotes
    Commercial Relationships   Lyndell Lim, Abbvie (F), Allergan (F), Bayer (F); Marios Constantinou, None; Sophie Rogers, None; Sukhpal Sandhu, None; Sanjeewa Wickremasinghe, Allergan (R), Bayer (R), Novartis (R); Salmaan Al-Qureshi, None
  • Footnotes
    Support  NHMRC Earky Career Fellowship (APP11093300); Diabetes Australia Research Trust Grant; Ramaciotti Health Investment Gramt
Investigative Ophthalmology & Visual Science July 2018, Vol.59, 1958. doi:
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      Lyndell L Lim, Marios Constantinou, Sophie Rogers, Sukhpal Singh Sandhu, Sanjeewa Wickremasinghe, Salmaan Al-Qureshi; The DiMECat Trial: A Prospective, Randomised Clinical Trial Of Intravitreous Bevacizumab vs. Triamcinolone In Patients With Diabetic Macular Oedema At The Time Of Cataract Surgery – 6 Month Results. Invest. Ophthalmol. Vis. Sci. 2018;59(9):1958.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : To compare visual and anatomical outcomes when either intravitreous bevacizumab (BVB, Avastin), or triamcinolone (TA, Triesence) is administered at the time of cataract surgery in patients with Diabetic Macular Oedema (DME).

Methods : The Dimecat study was a prospective, single-masked, randomised clinical trial conducted at The Royal Victorian Eye and Ear Hospital, Melbourne. Patients with clinically significant cataract and either centre-involving DME or DME that was treated in the previous 24 months were randomised 1:1 to receive intravitreal BVB 1.25mg or TA 4mg during cataract surgery, and at subsequent review if required over 6 months.
Main outcome measures were change in central macular thickness (CMT) and best corrected visual acuity at 1, 3 and 6 months post surgery (measured by masked observers).

Results : Sixty-one eyes from 58 patients with a mean age of 67 years, with 67.2% males were recruited. At baseline, the BVB group (n, 28 eyes) was similar to the TA group (n, 33 eyes) in terms of LogMAR letters and central macular thickness (p>0.2).

At six months, both groups had gained vision from baseline (mean +21.4 (95CI 14.5, 28.4) letters in the TA group (p<0.0001), +17.3 (95CI 12.1, 22.6) letters in the BVB group, p<0.0001), with no significant difference between the groups (p=0.346). However, only TA was associated with a sustained reduction in CMT (-51.4 (95CI -98.2 to -4.7) µm reduction with TA vs. +15.6 (95CI -26.4 to +57.7)µm increase with BVB, p=0.035 over 6 months).

During the 6 months of the study, 25 subjects (75.8%) avoided the need for any further treatments in the TA group compared to 12 (42.9%) in the BVB group (p=0.0088).

Conclusions : When administered at the time of cataract surgery in patients with DME, at 6 months both TA and BVB improve visual acuity, however only TA results in a sustained reduction in CMT. Further follow up will determine whether this translates into better long term visual outcomes in the TA group.

This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.

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