title: Comparison of intravitreal bevacizumab versus triamcinolone for the treatment of diffuse diabetic macular edema.
abstract: BACKGROUND
  Our purpose was to compare the effect of triamcinolone and bevacizumab (Avastin) on the retinal thickness and functional outcome in patients with diabetic macular edema.
  
  
  METHODS
  A collective of 32 patients, who had been treated by a single 4.0-mg intravitreal triamcinolone injection (group 1), was matched to 32 patients ('matched pairs'), who had received 3 injections of 1.25 mg of bevacizumab within 3 months in 4-week intervals (group 2). The outcome variables were changes in best corrected visual acuity (VA) and central retinal thickness 3 months after therapy.
  
  
  RESULTS
  Both groups did not differ regarding preoperative VA and central retinal thickness measured by optical coherence tomography. The baseline mean VA was 0.72 +/- 0.39 logMAR in group 1 and 0.73 +/- 0.39 logMAR in group 2 (p = 0.709). The mean central retinal thickness measured by optical coherence tomography was 548 +/- 185 mum in group 1 and 507 +/- 192 mum in group 2. While the patients in group 1 experienced a slight increase in VA of on average 0.7 lines following a single triamcinolone injection to a mean of 0.64 +/- 0.40 logMAR (p = 0.066) after 3 months, the patients in group 2 showed almost no effect on VA with an average increase of 0.2 lines to a mean VA of 0.72 +/- 0.30 logMAR (p = 0.948) following 3 intravitreal injections of bevacizumab. Comparing the effect on VA between both groups no statistically significant difference (p = 0.115) was noted. Concerning decrease in central retinal thickness both therapies were highly effective (p < 0.001 each), again, without statistically significant difference between the groups (p < 0.128).
  
  
  CONCLUSIONS
  Our data suggest that a single triamcinolone injection may be as effective as a 3 times repeated intravitreal administration of bevacizumab for the treatment of diabetic macular edema. Further prospective trials should be performed.
authors.affiliation: Department of Ophthalmology, Ludwig-Maximilians University, Munich, Germany.
authors.forename: Thomas C
authors.initials: TC
authors.lastname: Kreutzer
authors.forename: Rashid
authors.initials: R
authors.lastname: Al Saeidi
authors.forename: Daniel
authors.initials: D
authors.lastname: Kook
authors.forename: Armin
authors.initials: A
authors.lastname: Wolf
authors.forename: Michael W
authors.initials: MW
authors.lastname: Ulbig
authors.forename: Aljoscha S
authors.initials: AS
authors.lastname: Neubauer
authors.forename: Christos
authors.initials: C
authors.lastname: Haritoglou
mesh_terms: D000368:Aged; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized; D000068258:Bevacizumab; D003930:Diabetic Retinopathy / Q000150:complications; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007276:Injections, Intraventricular / Q000379:methods; D008269:Macular Edema / Q000188:drug therapy* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012160:Retina / Q000000981:diagnostic imaging / Q000473:pathology; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D041623:Tomography, Optical Coherence; D014221:Triamcinolone / Q000627:therapeutic use*; D014792:Visual Acuity / Q000187:drug effects / Q000502:physiology
chemical_list: D020533:Angiogenesis Inhibitors; D000893:Anti-Inflammatory Agents; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D014221:Triamcinolone; D000068258:Bevacizumab