Multicenter, Randomized Clinical Trial to Assess the Effectiveness of Intravitreal Injections of Bevacizumab, Triamcinolone, or Their Combination in the Treatment of Diabetic Macular Edema

Neto, Hermelino Oliveira; Regatieri, Caio V.; Nóbrega, Mário Junqueira; Muccioli, Cristina; Casella, Antonio M B; Andrade, Rafael; Maia, Maurício; Kniggendorf, Vinícius; Ferreira, Magno Antônio; Branco, André; Belfort, Rubens

doi:10.3928/23258160-20170829-08

Cited by 23 publications

(11 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Following title and abstract screening, 69 full-text articles were retrieved and screened for eligibility. Of them, 52 articles were excluded, and 17 RCTs (n = 1243 eyes) were reviewed in detail and included in this meta-analysis (PRISMA flow diagram; Fig 1A) [23,24,[30][31][32][33][34][35][36][37][38][39][40][41][42][43][44]. The references of the included RCTs were manually searched, but no further reports were added.…”

Section: Search Results and Characteristics Of Included Studiesmentioning

confidence: 99%

“…The references of the included RCTs were manually searched, but no further reports were added. All of the included studies were performed between 2007-2020, seven studies in Iran [31-33, 36, 42-44], four studies in Brazil [23,34,38,39], two studies in Egypt [35,40], and one study in Japan [30], India [37], Australia [41], and South Korea [24]. Seven studies compared IVB and IVT alone [23,30,34,35,38,41,42], 10 studies compared IVB vs. IVB+IVT [24, 31-33, 36, 37, 39, 40, 43, 44] and three studies compared IVT vs. IVB+IVT [24,39,40].…”

Section: Search Results and Characteristics Of Included Studiesmentioning

confidence: 99%

See 1 more Smart Citation

Intravitreal bevacizumab versus intravitreal triamcinolone for diabetic macular edema–Systematic review, meta-analysis and meta-regression

et al. 2021

View full text Add to dashboard Cite

Background The most frequent cause of vision loss from diabetic retinopathy is diabetic macular edema (DME). Earlier clinical trials tried to examine the role of intravitreal triamcinolone (IVT) and intravitreal bevacizumab (IVB) in DME; they either qualified IVT over IVB or IVB over IVT or did not exhibit a significant difference. Objective This paper aims to compare the efficacy and safety of IVB versus IVT alone or combined IVB+IVT in the treatment of DME. Methods We systematically searched PubMed, CENTRAL, Scopus, Embase, Science Direct, OVID, and Web of Science for randomized controlled trials of IVB versus IVT alone or combined IVB+IVT and IVT versus the combined IVB+IVT in DME patients. Results A total of 1243 eyes of 17 trials were included in our meta-analysis and regression. Repeated injections of IVB were superior at improving VA comparing with those of IVT at 12, 24, 48-weeks, and IVB+IVT at 12, 24, 48-weeks. Single injections were comparable across the three arms regarding BCVA improvement. CMT reductions were also comparable across the three arms. Meanwhile, the overall safety regarding intraocular pressure and intraocular hypertension significantly favored the IVB group. Improvement in VA was best modified with CMT reduction from 480 um to 320um. This association was significant at 12-weeks in the three arms and persisted till 24-weeks and 48-weeks exclusively in the IVB group. Conclusions and relevance Our analysis reveals that repeated successive injections associate with better BCVA compared to single injection. Current evidence affirms that IVB is superior to IVT and IVB+IVT at improving BCVA, comparable at reducing CMT, and presents a better safety profile in the treatment of DME.

show abstract

Section: Search Results and Characteristics Of Included Studiesmentioning

confidence: 99%

Section: Search Results and Characteristics Of Included Studiesmentioning

confidence: 99%

Intravitreal bevacizumab versus intravitreal triamcinolone for diabetic macular edema–Systematic review, meta-analysis and meta-regression

et al. 2021

View full text Add to dashboard Cite

show abstract

“…Clinical trials for diabetic retinopathy (Cai & Bressler ) and retinal dystrophies (Neto et al. ; Schatz et al. ) employ endpoints for central vision function aimed at preserving and/or improving Snellen VA, but patients may have multiple visual function deficits that are missed when Snellen VA is used alone.…”

Section: Discussionmentioning

confidence: 99%

Reading deficits in diabetic patients treated with panretinal photocoagulation and good visual acuity

Omari

Niziol

Gardner

2019

Acta Ophthalmologica

View full text Add to dashboard Cite

Purpose Patients with proliferative diabetic retinopathy (PDR) treated with panretinal photocoagulation (PRP) can have abnormal visual functioning that may be missed by Snellen visual acuity alone. We investigated reading deficits in patients treated with PRP for PDR using the Minnesota reading (MNREAD) test. Methods Thirty patients treated with PRP and 15 controls underwent best‐corrected visual acuity (BCVA), the MNREAD, frequency doubling perimetry (FDP), and fundus photography. Panretinal photocoagulation (PRP)‐treated subjects were compared to controls on MNREAD results by two‐sample t‐tests and Wilcoxon tests and Pearson correlations were used to assess the association between performance on MNREAD and other central visual function tests within PRP subjects. Results Panretinal photocoagulation (PRP)‐treated patients had reduced MNREAD acuity (p < 0.0001) and increased critical print size (p = 0.01) compared to controls but not a significantly reduced maximum reading speed (p = 0.06). Logmar MNREAD acuity was strongly positive correlated with logMAR BCVA (r = 0.58, p = 0.0098) and strongly negatively correlated with FDP foveal threshold (r = −0.63, p = 0.0030). Maximum reading speed was positively correlated with FDP foveal threshold (r = 0.57, p = 0.0143) and FDP mean deviation (r = 0.51, p = 0.0432). Visual acuity did not correlate with the sensitivities on the FDP. Conclusion The MNREAD test reveals that PRP reduces reading ability and other aspects of macular function, and thus provides new understanding of how vision‐related quality of life is impaired. These findings may lead to improved means to evaluate and enhance vision following treatment for PDR.

show abstract

“…Es gibt bislang keine Belege dafür, dass eine fixe Kombination verschiedener Therapiestrategien wie Lasertherapie [15] oder Steroide [37,39,163] [168]. Für das zugelassene 700 µg Dexamethason-Implantat wurde die Steigerung des Augendrucks innerhalb der Zulassungsstudie (MEAD-Studie) dokumentiert [16].…”

Section: Therapie Des Diabetischen Makulaödemsunclassified

Stellungnahme der DOG, der RG und des BVA zur Therapie des diabetischen Makulaödems

2020

Klin Monatsbl Augenheilkd

View full text Add to dashboard Cite

Multicenter, Randomized Clinical Trial to Assess the Effectiveness of Intravitreal Injections of Bevacizumab, Triamcinolone, or Their Combination in the Treatment of Diabetic Macular Edema

Abstract: Mono- or combination therapy was effective for DME treatment. No synergistic effects were observed; however, triamcinolone alone or a drug combination may reduce the number of injections required when compared to bevacizumab alone. [Ophthalmic Surg Lasers Imaging Retina. 2017;48:734-740.].

Cited by 23 publications

References 34 publications

Intravitreal bevacizumab versus intravitreal triamcinolone for diabetic macular edema–Systematic review, meta-analysis and meta-regression

Intravitreal bevacizumab versus intravitreal triamcinolone for diabetic macular edema–Systematic review, meta-analysis and meta-regression

Reading deficits in diabetic patients treated with panretinal photocoagulation and good visual acuity

Stellungnahme der DOG, der RG und des BVA zur Therapie des diabetischen Makulaödems

Contact Info

Product

Resources

About