Document Detail

Intravitreal triamcinolone versus bevacizumab for treatment of refractory diabetic macular oedema (IBEME study).
MedLine Citation:
PMID:  17965109     Owner:  NLM     Status:  MEDLINE    
BACKGROUND/AIMS: The aim of this study was to compare the morphological and visual acuity outcomes associated with a single intravitreal injection of triamcinolone acetonide versus bevacizumab for the treatment of refractory diffuse diabetic macular oedema.
METHODS: Twenty-eight patients were randomly assigned to receive a single intravitreal injection of either 4 mg/0.1 ml triamcinolone acetonide or 1.5 mg/0.06 ml bevacizumab. Comprehensive ophthalmic evaluation was performed at baseline and at weeks 1, 4, 8 (+/-1), 12 (+/-2) and 24 (+/-2) after treatment. Main outcome measures included central macular thickness measured with optical coherence tomography (OCT) and best corrected Early Treatment Diabetic Retinopathy Study (ETDRS) visual acuity.
RESULTS: Twenty-six patients (26 eyes) completed all study visits (two patients missed two consecutive study visits). Central macular thickness was significantly reduced in the intravitreal triamcinolone group compared with the bevacizumab group at weeks 4, 8, 12 and 24 (p<0.05). Logarithm of the minimum angle of resolution (LogMAR) best-corrected visual acuity was significantly higher at weeks 8 (0.69; approximately 20/100(+1)) and 12 (0.74; 20/100(-2)) in the intravitreal triamcinolone group compared with the bevacizumab group (weeks 8 (0.83; approximately 20/125(-1)) and 12 (0.86; 20/160(+2))) (p<0.05). Significant change from baseline in mean intraocular pressure (mmHg) was seen at week 4 (+2.25) only in the intravitreal triamcinolone group (p<0.0001). No patient had observed cataract progression during the study.
CONCLUSIONS: One single intravitreal injection of triamcinolone may offer certain advantages over bevacizumab in the short-term management of refractory diabetic macular oedema, specifically with regard to changes in central macular thickness. The actual clinical relevance of our preliminary findings, however, remains to be determined in future larger studies.
L Paccola; R A Costa; M S Folgosa; J C Barbosa; I U Scott; R Jorge
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Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2007-10-26
Journal Detail:
Title:  The British journal of ophthalmology     Volume:  92     ISSN:  1468-2079     ISO Abbreviation:  Br J Ophthalmol     Publication Date:  2008 Jan 
Date Detail:
Created Date:  2007-12-24     Completed Date:  2008-01-18     Revised Date:  2013-05-27    
Medline Journal Info:
Nlm Unique ID:  0421041     Medline TA:  Br J Ophthalmol     Country:  England    
Other Details:
Languages:  eng     Pagination:  76-80     Citation Subset:  IM    
Department of Ophthalmology, School of Medicine of Ribeirão Preto, Ribeirão Preto, SP, Brazil.
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MeSH Terms
Angiogenesis Inhibitors / therapeutic use
Antibodies, Monoclonal / therapeutic use*
Antibodies, Monoclonal, Humanized
Diabetic Retinopathy / drug therapy*,  pathology,  physiopathology
Follow-Up Studies
Glucocorticoids / therapeutic use
Immunosuppressive Agents / therapeutic use
Intraocular Pressure / drug effects
Macular Edema / drug therapy*,  pathology,  physiopathology
Middle Aged
Prospective Studies
Tomography, Optical Coherence
Treatment Outcome
Triamcinolone Acetonide / therapeutic use*
Visual Acuity / drug effects
Vitreous Body
Reg. No./Substance:
0/Angiogenesis Inhibitors; 0/Antibodies, Monoclonal; 0/Antibodies, Monoclonal, Humanized; 0/Glucocorticoids; 0/Immunosuppressive Agents; 2S9ZZM9Q9V/bevacizumab; 76-25-5/Triamcinolone Acetonide

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