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Bevacizumab vs Combined Bevacizumab and Triamcinolone for Refractory Diabetic Macular Edema: Six-Week Results of a Clinical Trial
Diabetic Retinopathy Highlights from Retina/Vitreous Free Papers
| Sunday, November 12, 2006 |
| Hamid Ahmedieh, MD, Ali Reza Ramezani, MD, Bijan Bijanzadeh, MD, Ali Tabatabaei, MD, Gholam Reza Keshavarsi, MD, Masoud Soheilian, MD, Mohammed Hossein Dehghan, MD, Siamak Moradian, MD, Mohsen Azarmina, MD, Homa Tabatabaei, MD, Sied Morteza Entezari, MD, Mohammed Sadegh Farahvash, MD, Mohammed Reza Mohebbi, MS, PhD
Combination use of pharmacological interventions with different modes of action for diabetic macular edema (DME) has been proposed to improve efficacy, safety, or durability of results compared to pharmacological monotherapy. Dr Ahmedieh reported the results of a randomized control trial of bevacizumab versus bevacizumab plus triamcinolone in 76 eyes of 76 patients with refractory DME randomly assigned to bevacizumab, bevacizumab and triamcinolone, or sham treatment. The sham treatment was performed by pressing a syringe without a needle onto the scleral surface at the usual injection site. At 6 weeks, the eyes in both treatment groups showed statistically significant improvements in visual acuity and central macular thickness relative to the sham group, although the absolute magnitude of these changes was not reported. Mild iritis was the most common side effect in the 41 eyes in the treated groups reported in the published abstract, affecting 42.9% and 44.4% of the bevacizumab and bevacizumab/triamcinolone groups, respectively. Other adverse effects were uncommon, with 1 patient in the bevacizumab group developing increased fibrous proliferation elsewhere. In the bevacizumab/triamcinolone group, 1 patient developed increased intraocular pressure.
Dr Avery congratulated Dr Ahmadieh on an interesting combination therapy trial. Nevertheless, all 3 panelists had concerns regarding the way that visual acuity was measured in this study. Dr Avery asked whether standardized or Snellen acuity was reported. Drs Haller and Aiello noted that differences in baseline visual acuity between the 2 groups might explain the differences noted in the results. |
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