Real-World Results of Intravitreal Ranibizumab, Bevacizumab, or Triamcinolone for Diabetic Macular Edema

Ophthalmologica. 2018;239(2-3):85-93. doi: 10.1159/000481180. Epub 2017 Oct 20.

Abstract

Objective: To compare the visual and anatomical outcomes of intravitreal ranibizumab (group 1), bevacizumab (group 2), and triamcinolone (group 3) for center-involving diabetic macular edema.

Methods: We retrospectively enrolled 275 eyes of 208 consecutive patients. Visual acuity (VA) in Early Treatment Diabetic Retinopathy Study (ETDRS) letters and central macular thickness (CMT) values on optical coherence tomography were extracted. Reported side effects were noted.

Results: At 6 months, the mean changes in VA in group 1, group 2, and group 3 were +4.9, +4.3, and +4.6 letters, respectively (p = 0.911). Improvement of CMT at 6 and 24 months was significantly better in group 3 compared to groups 1 and 2 (p = 0.012 and p = 0.001, respectively). At 24 months, the only independent variable affecting the change in VA was initial VA (p = 0.020). Cataract and glaucoma prevalences were higher in group 3 (p = 0.000 and p = 0.001, respectively).

Conclusions: Three treatment methods had similar effects with regard to improvement in VA; however, intravitreal triamcinolone provided additional anatomical improvement.

Keywords: Anti-VEGF agents; Corticosteroids; Diabetic macular edema; Injection; Intravitreal treatment.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial

MeSH terms

  • Angiogenesis Inhibitors / administration & dosage
  • Bevacizumab / administration & dosage*
  • Diabetic Retinopathy / complications
  • Diabetic Retinopathy / diagnosis
  • Diabetic Retinopathy / drug therapy*
  • Dose-Response Relationship, Drug
  • Female
  • Follow-Up Studies
  • Glucocorticoids / administration & dosage
  • Humans
  • Intravitreal Injections
  • Macular Edema / diagnosis
  • Macular Edema / drug therapy*
  • Macular Edema / etiology
  • Male
  • Middle Aged
  • Ranibizumab / administration & dosage*
  • Receptors, Vascular Endothelial Growth Factor / antagonists & inhibitors
  • Retrospective Studies
  • Tomography, Optical Coherence
  • Treatment Outcome
  • Triamcinolone / administration & dosage*
  • Visual Acuity*

Substances

  • Angiogenesis Inhibitors
  • Glucocorticoids
  • Triamcinolone
  • Bevacizumab
  • Receptors, Vascular Endothelial Growth Factor
  • Ranibizumab