Comparison of intravitrea injection of triamcinolone acetonide and bevacizumab as a primary treatment of diffuse diabetic macular edema

ABSTRACT

Introduction: Diabetic retinopathy is the leading cause of blindness in patients aged 20-74 years in the United States, Chew and Ferris [2001]. Diabetic macular edema [DME] is a manifestation of diabetic retinopathy that produces loss of central vision, Klein, et al., [1984]. Two different subtypes of DME are recognized. Focal macular edema, and diffuse macular edema, Ciardella, et al., [2004]. Intravitreal injection has been proposed as a new technique in the treatment, Jonas, et al., [2003]. Triamcinolone Acetonide [TA] is a synthetic glucocorticoid analog with marked anti-inflammatory action, used to take the advantage of its antiedematous effect, Jonas and Sofker [2001]. Anti-vascular endothelial growth factor [VEGF] therapy has probably been one of the most promising breakthroughs in medical retina treatment, Brwon, et al., [2006]. Bevacizumab, a full length monoclonal antibody binding all isoforms of VEGF, Michels, et al., [2005] and Moshfeghi, et al., [2006] . Bevacizumab is rapidly becoming one of the leading treatments for neovascular diseases,Fung, et al., [2006] and Jorge, et al., [2006]