Purpose: To review the functional and anatomical outcomes following intravitreal triamcinolone

Purpose: To review the functional and anatomical outcomes following intravitreal triamcinolone acetonide vs. Follow-up visits out to three months from baseline are reported. Results: One month after treatment baseline foveal thickness decreased from 452 μ to 299 μ in the IVTA group and from 292 μ to 270 μ in the IVB group. BCVA increased by two or more lines in 58.3% of eyes in the IVTA group and there was no similar improvement in the IVB group. In the IVTA group ABT-263 a transient increase in IOP (27-43 mmHg) occurred in four cases (16.7%) which was successfully controlled with topical medications. There were no complications in the IVB group. Conclusion: Short term outcomes indicate that intravitreal injection of bevacizumab was not associated with surgical complications compared to triamcinolone acetonide. Triamcinolone acetonide appears to be more effective treatment for Mouse monoclonal antibody to LRRFIP1. diabetic macular edema than bevacizumab. Keywords: Bevacizumab Diabetic Macular Edema Intravitreal Triamcinolone Retina Vascular Endothelial Growth Factor INTRODUCTION Diabetic macular edema (DME) is the major cause of visual impairment worldwide.1 Based on the observations of the early treatment diabetic retinopathy study (ETDRS) focal/grid laser photocoagulation is the accepted standard of care for DME. However only 17% of eyes showed any improvement in visual acuity (VA) and less than 3% of eyes experienced improvement of three or more lines after laser skin treatment.2-4 In diffuse DME the edema resolved in 68-94% of situations and visual acuity stabilized in 61% of situations. Visible acuity reduced by 3 or even more lines in 24 However.6% of eye despite treatment.5 Alternate treatments for DME are under investigation currently. For instance macular edema continues to be effectively reversed by intravitreal shot of varying dosages (1 to 21 mg) of triamcinolone acetonide in uveitis retinal vein occlusion chronic pseudophakic cystoid macular edema rays retinopathy and juxtafoveal telangiectasia.6-12 The most frequent dangers of intravitreal corticosteroids are mild to moderate elevation of intraocular pressure (IOP) ABT-263 as well as the advancement of cataract.13 14 However the pathogenesis of DME continues to be unidentified vascular endothelial development factor (VEGF) appears to are likely involved. Elevated degrees of VEGF in sufferers with DME in comparison to diabetics without maculopathy have ABT-263 already been reported.15 The upregulation of VEGF is connected with break down of the blood-retinal barrier with an increase of vascular permeability leading to retinal edema.16 Bevacizumab (Avastin Genentech Inc SAN FRANCISCO BAY AREA CA USA) a recombinant human monoclonal antibody directed against VEGF continues to be employed for cancer treatment.17 Intravitreal bevacizumab ABT-263 has surfaced being a therapeutic technique for retinal illnesses such as for example age-related macular degeneration and macular edema because of central retinal vein occlusion.18 19 Hence it really is reasonable to assume that VEGF inhibitors such as for example bevacizumab may also be applicable in other retinal illnesses such as DME. The purpose of this study was to compare practical and anatomic results of intravitreal triamcinolone acetonide and intravitreal bevacizumab in diffuse macular edema. MATERIALS AND METHODS This was a prospective randomized study that included 48 eyes of 32 subjects with diffuse macular edema not associated with vitreomacular traction. Diffuse DME was defined as retinal thickening measuring one disc diameter or higher with generalized leakage on fluorescein angiography and concomitant vision decrease. None of them of the individuals included in this study experienced previous laser therapy. All subjects underwent an ophthalmic exam that included measurement of best corrected snellen visual acuity (BCVA) optical coherence tomography (OCT) and fundus fluorescein angiography at demonstration. Fluorescein angiography was performed with digital images acquired every second upon injection of the dye until filling of retinal veins and acquisition of images of the macula during the late phase. OCT of each attention was performed with six linear scans oriented radially 30° apart and centered on the fovea. Central macular and foveal thicknesses were measured within a 3.45 mm diameter centered on the fovea. The circular map was subdivided into nine quadrants with the middle and the inner diameters at 2.22 mm and 1.00 mm.