Intravitreal Bevacizumab Versus Triamcinolone Acetonide for Refractory Uveitic Cystoid Macular Edema: A Randomized Pilot Study

J Ocul Pharmacol Ther. 2010 Apr;26(2):199-206. doi: 10.1089/jop.2009.0093.

Abstract

Purpose: To compare intravitreal bevacizumab (IVB) versus intravitreal triamcinolone acetonide (IVT) for treatment of refractory uveitic cystoid macular edema (CME).

Methods: In this randomized clinical trial, 31 eyes with uveitic CME were allocated into the IVB group-eyes that received 1-3 injections of 1.25 mg bevacizumab (15 eyes) and the IVT group-eyes that received 1-3 injections of 2 mg triamcinolone (16 eyes). Primary outcome measure was change in best-corrected visual acuity (VA) at 36 weeks.

Results: Visual acuity improvement compared with baseline values was meaningful in the IVB group at 12, 24, and 36 weeks (-0.35 + or - 0.45 logMAR [P = 0.016]) and in the IVT group at 24 and 36 weeks (-0.32 + or - 0.32 logMAR [P = 0.001]). A significant central macular thickness (CMT) reduction was observed only in the IVT group at week 36 (74.6 + or - 108.0 microm [P = 0.049]). Between-group analysis disclosed no significant difference in any outcome measure. By statistically removing the factor of cataract, the IVT group had more improvement in VA (P = 0.007).

Conclusions: IVB was as effective as IVT in refractory uveitic CME regarding VA improvement up to 36 weeks. Irrespective of triamcinolone-induced cataract, a more beneficial effect of IVT may be attainable.

Publication types

  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Angiogenesis Inhibitors / administration & dosage*
  • Antibodies, Monoclonal / administration & dosage*
  • Antibodies, Monoclonal, Humanized
  • Bevacizumab
  • Female
  • Glucocorticoids / administration & dosage*
  • Humans
  • Injections
  • Macular Edema / drug therapy*
  • Macular Edema / physiopathology
  • Male
  • Pilot Projects
  • Retina / pathology
  • Treatment Outcome
  • Triamcinolone Acetonide / administration & dosage*
  • Uveitis / drug therapy*
  • Uveitis / physiopathology
  • Vascular Endothelial Growth Factor A / antagonists & inhibitors*
  • Visual Acuity / physiology
  • Vitreous Body

Substances

  • Angiogenesis Inhibitors
  • Antibodies, Monoclonal
  • Antibodies, Monoclonal, Humanized
  • Glucocorticoids
  • Vascular Endothelial Growth Factor A
  • Bevacizumab
  • Triamcinolone Acetonide