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Comparative analysis of efficacy of intravitreal ranibizumab monotherapy (RM), triamcinolone monotherapy (TM) and simultaneous ranibizumab and triamcinolone (SRT); in patients with diabetic macular edema (DME)

Session Details

Session Title: Vascular Diseases II

Session Date/Time: Friday 27/09/2013 | 11:00-12:30

Paper Time: 11:16

Venue: Hall F (Level 2)

First Author: M.Gupta INDIA

Co Author(s):    P. Malik   V. Vohra   J. Kashyap   A. Anind     

Abstract Details


To compare the efficacy of ranibizumab (0.5mg) monotherapy versus ranibizumab combined with triamcinolone or triamcinolone (4mg) alone, based on mean change in best-corrected visual acuity (BCVA) and central macular thickness (CMT) on Optical Coherence tomography (OCT) imaging ,over 6 months in type II Diabetes patients with Macular Edema.


Retina Services at a prime government hospital in the capital state of India.


Sixty eyes with visual acuity of 20/200 or better, with OCT proven DME >250 microns were randomly allocated to three separate arms; RM arm receiving 0.5mg of intravitreal Ranibizumab alone (n=20), TM arm receiving 4mg of intravitreal Triamcinolone alone (n=20) and SRT arm receiving simultaneous intravitreal injections of Ranibizumab 0.5mg and Triamcinolone 4mg (n=20), at baseline and monthly intervals for three consecutive months. Final visual acuity(VA) and CMT were assessed at the end of 6 months.


Mean changes (±SD) in visual acuity letter score from baseline was significantly better in the simultaneous ranibizumab and triamcinolone (+4 ± 11 P < 0.001) arm compared with those in the ranibizumab monotherapy arm (+2 ± 14) and triamcinolone arm (+2 ± 8), at the end of 6 month period, mirroring retinal thickening results.


Results of this study suggest that SRT is more effective for improving VA in DME than either drug alone, as has been conventionally considered. However, the sample size of this study is small and further research is warranted before this result can be established for clinical use; nonetheless the implications of this are vast and crucial.

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