[Intravitreal injection of bevacizumab versus triamcinolone acetonide in patients with refractory CME]

ABSTRACT

To compare intravitreal bevacizumab [IVB] with intravitreal triamcinolone acetonide [IVT] for treatment of refractory uveitic cystoid macular edema [CME]. In this randomized clinical trial, 31 eyes with uveitic CME were allocated into 2 groups the IVB group, received one to three injections of 1.25 mg bevacizumab [15 eyes]; the IVT group received one to three injections of 2mg triamcinolone [16 eyes]. The primary outcome measure was change in best-corrected visual acuity [BCVA] at 36 weeks. Visual acuity improvement as compared to baseline values was meaningful in the IVB group at 12, 24, and 36 weeks and in the IVT group at 24 and 36 weeks. A significant reduction in central macular thickness [CMT] was observed only in the IVT group at week 36 [74.6?108.0 microm [P=0.049]]. Intergroup analysis however, disclosed no significant difference in any of the outcome measures. By removing the effect of cataracts, IVT had a better improving effect on VA [P=0.007]. No significant systemic side effect was observed during the study period. IVB was as effective as IVT in refractory uveitic CME regarding VA improvement. Irrespective of triamcinolone-induced cataract, the effect of IVT may be superior to IVB