Combined Therapy of Intravitreal Bevacizumab and Posterior Subtenon Triamcinolone Acetonide Injection in Diabetic Macular Edema

ABSTRACT

PURPOSE: To investigate the outcomes of the combined therapy of intravitreal bevacizumab (IVB) and posterior sutbtenon triamconolone acetonide (STTA) injections as compared to single injections of each in patients with diabetic macular edema (DME). METHODS: IVB injection (IVB group), STTA injection (STTA group) and combined therapy injection (combined group) were performed randomly for 90 eyes (83 patients) diagnosed with DME. Changes in central macular thickness (CMT), best corrected visual acuity (BCVA) and intraocular pressure (IOP) were compared among groups prospectively at pre-injection and one, three and six months after injection. RESULTS: Reduction of CMT and improvement of BCVA were maintained for three months after treatment in all groups, but CMT and BCVA deteriorated at six months after treatment. The combined therapy group revealed significant reductions in CMT and improvement of BCVA (p=0.003, p=0.021, respectively) for the first month compared to the single treatment group. Elevated IOPs were found in three cases and there was no endophthalmitis or retinal detachment. CONCLUSIONS: The combined therapy injection showed significant early improvements in CMT and BCVA for one month. Additionally, the combined therapy revealed similar outcomes as compared with each single treatment after three months.