Posters

Comparision of intravitreal dexamethasone implant versus intravitreal bevacizumab along with triamcinolone acetonide injection in diffuse diabetic macular edema

Poster Details

First Author: K.Kumar INDIA

Co Author(s):    S. Latha   A. Agarwal                          

Abstract Details



Purpose:

To compare the efficacy of intravitreal combination therapy with Ozurdex® implant as primary treatment for severe form of diffuse DME (DDME). Intravitreal corticosteroid implant is superior to combination therapy for DDME

Setting:

The study was done at a tertiary centre in South India

Methods:

Non-randomized, prospective interventional comparative study. Consecutive patients with DME having CMT>450µ, diffuse leakage on FFA and BCVA between 20/200 to 20/40, received either dexamethasone implant (Group A) or Intravitreal bevacizumab plus triamcinolne acetonide (Group B) injections. Treatment-naive patients were only included for study. Efficacy of the treatment was considered as mean improvement of visual acuity of >2lines (LogMAR of >0.2) and reduction in mean CMT of >250µ

Results:

Study included 40 eyes of 34 patients with mean age of 57±6 years. Mean BCVA improved from 0.8 to 0.2 LogMAR and mean OCT reduced from 528 ±184to 245±85µ at 24 weeks (p<0.05). BCVA improved significantly from 0.94 to 0.16 in group A and 0.68 to 0.13 LogMAR units in group B; mean OCT reduced significantly from 591 to 233µ in group A and 465 to 223µ in group B at 24 weeks (p<0.05). Improvement in BCVA and CMT between two groups were comparable at 24 weeks (p=0.26; p=0.31). Retreatment criteria included reduction in BCVA of 2 or more lines and or increase of CMT >150µ at 16 weeks. 5 (26%) eyes in group A and 14 (70%) eyes in group B receieved reinjections. Final CMT following reinjections were comparable between two groups (p=0.12). 2(10%) patients in group A and 8 (40%) patients in group B had transiently increased IOP, controlled medically. No cases of cataract progression attributed to steroid was seen in any of the groups

Conclusions:

Intravitreal dexamethasone implant and combined IVB plus TA are equally efficacious as primary treatment for severe diabetic macular edema with anatomical and functional effectiveness at 6 months. Side effects were rare and manageable in our practice. Combination therapy can be offered to patients who cannot afford Ozurdex® implant for severe DDME

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