| Objective: To evaluate the clinical effect of intravitreal bevacizumab combined with triamcinolone acetonide in patients with diabetic macular edema (DME).Methods: Thirty-two eyes with DME inpatients or outpatients in our hospital from August 2009 to September 2010 were randomly divided in to Combination injection group of 18 cases with 20 eyes and single injection group of 14 cases with 20 eyes. Combination injection group were treated with intravitreal bevacizumab (1.25mg/ 0.05mL ) , triamcinolone acetonide (2mg/0.05mL ) and the single injection group group received intravitreal triamcinolone acetonide(IVTA 2mg/0.05mL ) alone. The visual acuity of LogMAR, intraocular pressure(IOP),central retinal macular thickness (CMT) by optical coherence tomography(OCT) and the fundus fluorescein angiography (FFA) macular changes were observed and recorded.Results:The Visual acuity of Combination injection group and single injection group were respectively 0.57±0.11,0.60±0.54,had significant difference at a week (t=4.079,P<0.001),(t=6.496,P<0.001), while there were no statistically significant difference between groups (t=-0.981,P=0.333) ; The difference was statistically significant after injection (1m , 2m, 3m) between the groups (t =- 3.278,P = 0.003), (t =- 5.739,P <0.001), (t =- 4.072,P <0.001),the LogMAR of Combination injection group were:0.53±0.84,0.48±0.70,0.50±0.732,and single injection group were:0.60±0.53,0.60±0.52,0.60±0.87 . CMT results,after injection 1m,2m,3m,the CMT of Combination injection group were:348.33±36.66,356.88±40.73,368.06±40.50;and single injection group were:350.00±27.65,358.82±26.97,369.21±26.18,comparing between each group of two groups: there were no significant difference between the groups(t=-0.161,P=0.873),(t=-0.178,P=0.860),(t=-0.107,P=0.916), the CMT were significant difference after treatment between each group respectively(P<0.001).Intraocular pressure: after injection 1w,1m,2m,3m, the intraocular pressure of Combination injection group were:16.62±1.24,16.57±0.91,16.91±1.57,16.79±1.81,and single injection group were:16.69±1.52,16.80±1.16,16.39±0.86,16.66±1.26.comparing each group, the IOP after injection were no significant difference at one week, 1w(t=-0.144,P=0.804),1m(t=-0.684,P=0.468),2m(t=1.306, P=0.208),3m(t=0.265,P=0.474), the IOP were significant difference after treatment between each group respectively(P<0.001).The IOP of combination injection group was superior to the single injection group(≤21mmHg). In the single injection group, the visual acuity of five patients were decreased again in 2 months. Three of forty eyes had little flaky exfoliation in the corneal epithelium at one day after treatment, 6 eyes had small flakes subconjunctival hemorrhage in the injection site after treatment, but was absorbed after 1w. No other ophthalmic and systemic complications.Conclusions:Intravitreal bevacizumab combined with triamcinolone acetonide injection in patients with DME has obvious clinical effect. Intravitreal bevacizumab combined with triamcinolone acetonide injection is a safe, reliable, convenient and economical treatment of diabetic macular edema. |
PDF Full Text Request