Intravitreal Combination of Triamcinolone Acetonide and Bevacizumab (Kenacort-Avastin) in Diffuse Diabetic Macular Edema

Tsilimbaris, Miltiadis K.; Pandeleondidis, V.; Panagiototglou, Theoni; Arvanitaki, Vassiliki; Fragiskou, S; Eleftheriadou, Maria; Tsika, Chrysanthi; Papadaki, Theokliti

doi:10.3109/08820530903389775

Cited by 10 publications

(5 citation statements)

References 29 publications

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“…21 Tsilimbaris MK et al found out major decrease in central macular thickness and superior best corrected visual acuity in group with combined IVB-IVTA and showed this therapy to be very effective. 22 In all of these studies, results are comparable to our study supporting combined simultaneous use of bevacizumab with corticosteroids to be more favorable with better outcomes.…”

Section: Discussionsupporting

confidence: 85%

Intravitrealversus Posterior Subtenon Triamcinolone Acetonide in Conjunction with Intravitreal Bevacizumab for Refractory Diabetic Macular Edema

Gull

Niazi

Raza³

2022

pak J Ophthalmol

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Purpose Aim of this study was to evaluate and compare the effects of combined simultaneous injection of intravitreal triamcinolone acetonide and bevacizumab versus intravitreal bevacizumab and posterior subtenon triamcinolone acetonide in treatment of persistent refractory diabetic macular edema after intravitreal bevacizumab injection failure Methods 40 pseudophakic diabetic patients were enrolled in quasi experimental study conducted at ophthalmology department. All eyes were specifically diagnosed with persistent refractory diabetic macular edema with central retinal thickness of _____on OCT. Patients were divided into two groups. Group A was given simultaneous injection of intravitreal bevacizumab 1.25mg/0.05ml with posterior subtenon triamcinolone 40mg and group B was given intravitreal bevacizumab in conjunction with simultaneous intravitreal triamcinolone 2mg/0.05 ml.Patients were followed upmonthly till three months. Changes in the best corrected visual acuity, intraocular pressure and central retinal thickness by optical coherence tomography were evaluated in both groups. Retreatment was given at 12 weeks interval whenever indicated by OCT. Results Group B showed a more significant decrease in the median CRT at 1month (p =0.0002)but after 3 months both groups showed a reduction in CRT which was not statistically significant between two groups _____. Both groups had significant improvement in BCVA compared to pre-injection baseline visual acuity.Between two groups BCVA changes were not statistically significant at 3 months _____.Five eyes in group B developed IOP beyond 22mmHg, which was treated with anti glaucoma medications within 2 weeks. No eye in group A developed IOP greater than 21mmHg. At 12 weeks, 7 of group A patients and 6 of group B patients developed recurrent macular edema and required repeated injections. Conclusion While treating persistent refractory diabetic macular edema, posterior subtenon triamcinolone is as effective as intravitreal triamcinolone in conjunction with intravitreal bevacizumab in reducing CRT and improving and stabilizing BCVA but in terms of IOP rise posterior subtenon injection is safer as compared to intravitreal injection. Both treatments are cost effective and combined simultaneous injections decrease the number of repeated injections.

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Section: Discussionsupporting

confidence: 85%

Intravitrealversus Posterior Subtenon Triamcinolone Acetonide in Conjunction with Intravitreal Bevacizumab for Refractory Diabetic Macular Edema

Gull

Niazi

Raza³

2022

pak J Ophthalmol

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“…The quantitative predictions, with forecasting over a relatively short time, open opportunities for the eventual prevention of the development of the first signs of retinal vascular diabetic retinopathy and sight‐threatening retinal oedema. There are numerous recent experimental treatments of advanced diabetic retinopathy, such as injections of steroids and anti‐vascular endothelial growth factor agents, which have been successful in some patients 46,47 . The most recent studies suggest that a combination of these treatments might be even more effective in reducing visual loss but a preventative measure that is less invasive is still needed for diabetic patients 48 .…”

Section: Discussionmentioning

confidence: 99%

Retinal neuropathy precedes vasculopathy in diabetes: a function‐based opportunity for early treatment intervention?

Adams

Bearse

2012

Clinical and Experimental Optometry

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Diabetes, now at epidemic levels, can have devastating effects on the eye and vision. Treatments of the ocular complications are currently focused on relatively advanced stages and are limited to the slowing down of the progressive sight-threatening retinal vasculopathy (diabetic retinopathy). Tiny signals from the neural retina have been shown to reveal early diabetic neuropathy prior to vascular retinopathy. These signals, in a clinical test format, are predictive, by precise retinal location, of impending vasculopathy in the retina within a year, including sight-threatening oedema. The discovery opens possibilities for the future development of treatments to prevent the onset of retinopathy and the more sight-threatening retinal oedema and changes patient management strategies.

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“…Before the administration of the drugs, the IOP was 15.6 ± 2.3 (range 11-20) mmHg in the STTA-treated eyes and 15.7 ± 2.8 (range [11][12][13][14][15][16][17][18][19][20] mmHg in the control eyes, and there was no significant difference between them (P = 0.927). After the initial IVB injection, the IOP in the STTA-treated eyes increased steeply and, after 24 weeks, significantly increased, while the IOP in the control eyes b Reduction ratio (refer to the text) in eyes with (black bar) and without (white bar) STTA.…”

Section: Alteration Of Iopmentioning

confidence: 63%

“…A significant difference was found between the 2 groups (P = 0.008) Reduction in the frequency of intravitreal bevacizumab administrations achieved by posterior… with IVTA and bevacizumab, and the authors concluded that IVTA/IVB induced earlier functional and morphological regression than did IVB, although the prognoses did not differ significantly between IVTA/IVB and IVB [17,18]. Although the efficacy of combined IVTA/IVB for DME was reported [19], the beneficial inferiority of IVTA/ IVB to IVB owing to treatment complications was also pointed out [20,21].…”

Section: Discussionmentioning

confidence: 86%

Reduction in the frequency of intravitreal bevacizumab administrations achieved by posterior subtenon injection of triamcinolone acetonide in patients with diffuse diabetic macular edema

et al. 2016

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Intravitreal Combination of Triamcinolone Acetonide and Bevacizumab (Kenacort-Avastin) in Diffuse Diabetic Macular Edema

Abstract: Intravitreal combination of Triamcinolone Acetonide and Bevacizumab seems to be effective in improving visual acuity and macular edema in patients with diabetic maculopathy.

Cited by 10 publications

References 29 publications

Intravitrealversus Posterior Subtenon Triamcinolone Acetonide in Conjunction with Intravitreal Bevacizumab for Refractory Diabetic Macular Edema

Intravitrealversus Posterior Subtenon Triamcinolone Acetonide in Conjunction with Intravitreal Bevacizumab for Refractory Diabetic Macular Edema

Retinal neuropathy precedes vasculopathy in diabetes: a function‐based opportunity for early treatment intervention?

Reduction in the frequency of intravitreal bevacizumab administrations achieved by posterior subtenon injection of triamcinolone acetonide in patients with diffuse diabetic macular edema

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