COMPARISON OF INTRAVITREAL BEVACIZUMAB (AVASTIN) WITH TRIAMCINOLONE FOR TREATMENT OF DIFFUSED DIABETIC MACULAR EDEMA: A PROSPECTIVE RANDOMIZED STUDY

Objectives: Despite the high prevalence of diabetic macular edema (DME), there is no definite treatment because of its complicated pathophysiologic mechanism, which is still not fully understood. This study was performed to compare the efficacy of intravitreal bevacizumab (IVB) with intravitreal triamcinolone acetonide (IVT) in patients exhibiting diffused DME. Methods: In this randomized clinical trial, eligible eyes were assigned randomly to one of the three study arms: the IVB group, patients who received 1.25 mg IVB (30 eyes); the IVT group, patients who received 2 mg of IVT (30 eyes); and the MPC group, patients who underwent modified grid laser (30 eyes). The eyes of the IVB and IVT patients underwent macular grid photocoagulation 3 weeks afterward. Main outcome measures included change in central macular thickness (CMT) and change in best-corrected visual acuity (BCVA) 6 and 12 weeks after injection. Results: There was no difference between the IVB and IVT groups in terms of BCVA improvement a both 6 weeks (p=0.532) and 12 weeks (p=0.751). In both IVB and IVT groups, BCVA improved significantly from baseline to 6 and 12 weeks compared with MPC group. CMT decreased more in the IVB group than it did in the IVT group during the follow-up period (p=0.036). CMT decreased significantly in both IVB and IVT groups compare with MPC group. Conclusion: The results of our study revealed that both IVB and IVT may be effective in the treatment of diffused DME compared with macular grid augmentation. However, IVB may offer certain advantages over triamcinolone in the short-term management of diffused DME. Key words: Diabetic macular edema, Intravitreal bevacizumab, Intravitreal triamcinolone, Laser photocoagulation, Best corrected visual acuity, Central macular thickness.