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ISSN 1561-3070 (Electronic)

2016, Number 1

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Rev Cub Oftal 2016; 29 (1)

Intravitreal bevacizumab versus bevacizumab and triamcinolone for the diabetic macular edema

Vila DI, Ramos LM, Pérez VEL, Ruiz MM, Pereira ME, Padilla GCM

Language: Spanish
References: 26
Page: 16-25
PDF size: 199.27 Kb.


ABSTRACT

Objective: to evaluate the use of intravitreal bevacizumab injection alone or combined with triamcinolone as well as the adverse effects and the correlation between the best corrected visual acuity and the central macular thickness.
Methods: prospective, longitudinal and observational double-blinded case control study performed in 90 patients with untreated diabetic macular edema and no vitreous traction in the vitreous-retina service of "Ramón Pando Ferrer" Institute of Ophthalmology of Cuba. They were randomly divided into 3 groups for treatment: a control group treated with laser, another one with intravitreal bevacizumab (1,25 mg in 0,05 mL) and the other with bevacizumab plus triamcinolone (1,25 mg in 0,05 mL plus 4 mg in 0,1 mL, respectively). Each group had 30 patients, with progress evaluated at 6, 12, 16, 24, 30 weeks and one year.
Results: the best corrected visual acuity after a year of treatment did not have statistical significant in any of the three groups (p= 0,099). In the laser-treated group, 40 % improved two or more lines in the Snellen chart, followed by bevacizumab group (20 %) and that of bevacizumab plus triamcinolone (10 %). There was significant difference (p= 0,001) in the central macular thickness decrease after one year in the three groups, being the laser group the one with highest decrease rate (60 %). The group treated with intravitreal bevacizumab plus triamcinolone achieved the best results in reducing the central macular thickness but this result did not remain after a year. However, the laser treatment showed a more stable reduction of the macular thickness.
Conclusions: macular photocoagulation for the diabetic macular edema is more effective one year after treatment in reducing the macular thickness and achieving the best corrected visual acuity.


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