2M.D. Professor, Süleyman Demirel University Faculty of Medicine, Department of Ophthalmology, Isparta/TURKEY Objectives: To investigate the efficacy and safety of combined intravitreal triamcinolone acetonide (IVTA) and bevacizumab (IVB) injection diffuse diabetic macular edema (DME) refractory to anti-vascular endothelial growth factor.
Materials and Methods: Twelve eyes of 12 diabetic patients (M/F:5/7, mean age 64.58±4.85 years) who were diagnosed as refractory DME to anti-VEGF injections were included in this study. Patients underwent combined injection of IVTA (preserver removed, 2 mg, 0.05 ml) and IVB (1.25 mg, 0.05 ml). The best-corrected visual acuity (BCVA), intraocular pressure (IOP) and central macular thickness (CMT) were measured at baseline, one, three, and six months (respectively) after combined IVB-IVTA injection.
Results: The mean CMTs were 441.75±61.39 µ (mean±standart deviation), 392.83±68.24 µ, 325.67±66.67 µ, and 387.58±57.02 µrespectively. The mean BCVAs were 1.08±0.80 Log MAR, 0.82±0.71 Log Mar, 0.84±0.72 Log MAR, and 1.01±0.87 Log Mar respectively. The values of both BCVA and CMT at one, two, and three months were significantly improved from baseline ( p<0.05). After 6 months following combined injection 10 (%83.3) patients needed IV injection. Following the injection there was not any intra ocular reaction or inflammation. There were 4 (%33.3) patients with high IOP and their IOP\'s became normal with topical anti glaucomatous treatment.
Conclusions: Combined IVTA-IVB injection is safe and effective procedure diffuse DME refractory to anti-VEGF therapy.
Keywords : Bevacizumab, diabetic macular edema, triamcinolone acetonide