Comparison of efficacy and safety between intraocular becacizumab and triamcinolone for diabetic macular edema / 中华实验眼科杂志

ABSTRACT

Background Diabetic macular edema is the primary complication of diabetes.Becacizumab and triamcinolone acetonide(TA) have been intravitreally used to treat diabetic macular edema,but it is necessary to compare and evaluate their efficacy and safety.Objective The aim of this trial was to discuss and compare the safety and efficacy of intravitreal injection of becacizumab and TA for diabetic macular edema.Methods A case-controlled study was designed.In this pilot clinical trial,total 98 eyes of 98 patients determined as diabetic macular edema by optical coherence tomography(OCT) and fluorescine funds angiography(FFA) were assigned to becacizumab group and TA group according to the visiting time.Becacizumab of 0.05ml(1.25mg) was injected into vitreous via 4mm posterior to limbus in becacizumab group and TA of 0.1ml(4mg) was used at the same way.The visual acuity,central macular thickness(CMT) and intraocular pressure(IOP) were examined before and 4,8,12 weeks after injection.The complication after injection was compared between these two groups.This study was approved by Ethic Committee of Xi'an Central Hospital.Written informed consent was obtained from each patient prior to this protocol.Results All of the patients finished the medical procedure and follow-up.No significant differences were found in the demographic characteristics between two groups(P＞0.05).The vision was obviously improved in both becacizumab group and TA group in 4,8,12 weeks after injection in comparison with before injection(P＜0.01),but no evident differences were seen in vision at various time points between two groups (P＞0.05).The CMT values were reduced after injection compared with before injection in both two groups(P＜0.01),however,there was no any difference was found in CMT value between becacizumab group and TA group whatever before and after injection(P＞0.05).In 4,8,12 weeks after intravitreous injection,the IOPs were elevated in TA group compared with becacizumab group(P＜0.05,P＜0.01),and the IOP was higher after injection than that before injection in TA group(P＜0.01).The incidence of increased IOP after intravitreal injection of TA was 14.3%.No complication was observed in becacizumab group during the follow-up duration.Conclusion Both becacizumab and TA can treat diabetic macular edema by intravitreal administration.Intravitreal injection of TA may be the more favorable therapy for diabetic macular edema in comparison with becacizumab.However,this outcome indicate that IOP should be monitored during the follow-up period.