Razi Journal of Medical Sciences

    Background & Aim: Macular photocoagulation is the standard treatment for clinically significant macular edema (CSME), but some of patients do not respond to it. The aim of this study was to compare the results of intravitreal injection of triamcinolone acetonide (IVTA) and bevacizumab (IVB) in patients with CSME.

Patients and Method: In this prospective randomized double-blind clinical trial, 51 eyes with CSME with at least one session of MPC (Macular Photocoagulation) and without response to it were included. The patients were randomly assigned to one injection of either 4 mg of IVTA or 1. 25 mg of IVB. Visual acuity (VA), intraocular pressure (IOP) and cataract were checked before and 1, 3 and 6 months after injection. Fluorescein angiography was performed before and 3 and 6 months after injection to evaluate macular integrity and leakage. Data were analyzed using Chi-square, Students' t-test and Friedman tests.

Results: No significant change in VA was seen in either group in the first, third and sixth months of follow-up. There was no significant difference between the two groups in terms of VA 1, 3 and 6 months after injection. Although the measurements taken during the follow-up revealed an increase in IOP in IVTA group, the difference between the two groups was not significant. There was no increase in cataract formation in IVB group however, the incidence of posterior subcapsular cataract significantly increased in IVTA group 6 months after injection (P<0. 001).

Macular leakage and angiographic resolution were improved significantly in the two groups (P<0.001), but no significant change was noted in foveal avascular zone visualization. Overall, the measurements taken after 3 and 6 months showed no significant difference between the two groups in terms of angiographic features.

Conclusion: According to this study, the efficacy of IVB is the same as IVTA in the treatment of CSME unresponsive to standard treatment.