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Intravitreal triamcinolone versus bevacizumab for treatment of refractory diabetic macular oedema (IBEME study)

Paccola, L ; Costa, R A ; Folgosa, M S ; Barbosa, J C ; Scott, I U ; Jorge, R

British journal of ophthalmology, 2008-01, Vol.92 (1), p.76-80 [Periódico revisado por pares]

BMA House, Tavistock Square, London, WC1H 9JR: BMJ Publishing Group Ltd

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Título:
Intravitreal triamcinolone versus bevacizumab for treatment of refractory diabetic macular oedema (IBEME study)
Autor: Paccola, L ; Costa, R A ; Folgosa, M S ; Barbosa, J C ; Scott, I U ; Jorge, R
Assuntos: Aged ; Angiogenesis Inhibitors - therapeutic use ; Antibodies, Monoclonal - therapeutic use ; Antibodies, Monoclonal, Humanized ; Bevacizumab ; Biological and medical sciences ; Cataracts ; Diabetes ; Diabetes. Impaired glucose tolerance ; Diabetic retinopathy ; Diabetic Retinopathy - drug therapy ; Diabetic Retinopathy - pathology ; Diabetic Retinopathy - physiopathology ; Endocrine pancreas. Apud cells (diseases) ; Endocrinopathies ; Etiopathogenesis. Screening. Investigations. Target tissue resistance ; Female ; Follow-Up Studies ; Glaucoma ; Glucocorticoids - therapeutic use ; Heart attacks ; Humans ; Hypertension ; Immunosuppressive Agents - therapeutic use ; Injections ; Intraocular Pressure - drug effects ; Lasers ; Macular degeneration ; Macular Edema - drug therapy ; Macular Edema - pathology ; Macular Edema - physiopathology ; Male ; Medical imaging ; Medical sciences ; Middle Aged ; Miscellaneous ; Morphology ; Ophthalmology ; Prospective Studies ; Short term ; Software ; Tomography, Optical Coherence ; Treatment Outcome ; Triamcinolone Acetonide - therapeutic use ; Visual Acuity - drug effects ; Vitreous Body
É parte de: British journal of ophthalmology, 2008-01, Vol.92 (1), p.76-80
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Descrição: Background/aims:The aim of this study was to compare the morphological and visual acuity outcomes associated with a single intravitreal injection of triamcinolone acetonide versus bevacizumab for the treatment of refractory diffuse diabetic macular oedema.Methods:Twenty-eight patients were randomly assigned to receive a single intravitreal injection of either 4 mg/0.1 ml triamcinolone acetonide or 1.5 mg/0.06 ml bevacizumab. Comprehensive ophthalmic evaluation was performed at baseline and at weeks 1, 4, 8 (±1), 12 (±2) and 24 (±2) after treatment. Main outcome measures included central macular thickness measured with optical coherence tomography (OCT) and best corrected Early Treatment Diabetic Retinopathy Study (ETDRS) visual acuity.Results:Twenty-six patients (26 eyes) completed all study visits (two patients missed two consecutive study visits). Central macular thickness was significantly reduced in the intravitreal triamcinolone group compared with the bevacizumab group at weeks 4, 8, 12 and 24 (p<0.05). Logarithm of the minimum angle of resolution (LogMAR) best-corrected visual acuity was significantly higher at weeks 8 (0.69; ∼20/100+1) and 12 (0.74; 20/100−2) in the intravitreal triamcinolone group compared with the bevacizumab group (weeks 8 (0.83; ∼20/125−1) and 12 (0.86; 20/160+2)) (p<0.05). Significant change from baseline in mean intraocular pressure (mmHg) was seen at week 4 (+2.25) only in the intravitreal triamcinolone group (p<0.0001). No patient had observed cataract progression during the study.Conclusions:One single intravitreal injection of triamcinolone may offer certain advantages over bevacizumab in the short-term management of refractory diabetic macular oedema, specifically with regard to changes in central macular thickness. The actual clinical relevance of our preliminary findings, however, remains to be determined in future larger studies.
Editor: BMA House, Tavistock Square, London, WC1H 9JR: BMJ Publishing Group Ltd
Idioma: Inglês

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Intravitreal triamcinolone versus bevacizumab for treatment of refractory diabetic macular oedema (IBEME study)

Paccola, L ; Costa, R A ; Folgosa, M S ; Barbosa, J C ; Scott, I U ; Jorge, R

BMA House, Tavistock Square, London, WC1H 9JR: BMJ Publishing Group Ltd

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