Intravitreal bevacizumab versus triamcinolone acetonide for refractory uveitic cystoid macular edema: a randomized pilot study.

Abstract

PURPOSE:

To compare intravitreal bevacizumab (IVB) versus intravitreal triamcinolone acetonide (IVT) for treatment of refractory uveitic cystoid macular edema (CME).

METHODS:

In this randomized clinical trial, 31 eyes with uveitic CME were allocated into the IVB group-eyes that received 1-3 injections of 1.25 mg bevacizumab (15 eyes) and the IVT group-eyes that received 1-3 injections of 2 mg triamcinolone (16 eyes). Primary outcome measure was change in best-corrected visual acuity (VA) at 36 weeks.

RESULTS:

Visual acuity improvement compared with baseline values was meaningful in the IVB group at 12, 24, and 36 weeks (-0.35 + or - 0.45 logMAR [P = 0.016]) and in the IVT group at 24 and 36 weeks (-0.32 + or - 0.32 logMAR [P = 0.001]). A significant central macular thickness (CMT) reduction was observed only in the IVT group at week 36 (74.6 + or - 108.0 microm [P = 0.049]). Between-group analysis disclosed no significant difference in any outcome measure. By statistically removing the factor of cataract, the IVT group had more improvement in VA (P = 0.007).

CONCLUSIONS:

IVB was as effective as IVT in refractory uveitic CME regarding VA improvement up to 36 weeks. Irrespective of triamcinolone-induced cataract, a more beneficial effect of IVT may be attainable.

• Authors: Masoud Soheilian, Zahra Rabbanikhah, Alireza Ramezani, Victoria Kiavash, Mehdi Yaseri, Gholam A Peyman
• Journal: Journal of ocular pharmacology and therapeutics : the official journal of the Association for Ocular Pharmacology and Therapeutics (J Ocul Pharmacol Ther) Vol. 26 Issue 2 Pg. 199-206 (Apr 2010) ISSN: 1557-7732 [Electronic] United States
• PMID: 20307215 (Publication Type: Comparative Study, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Angiogenesis Inhibitors
• Antibodies, Monoclonal
• Antibodies, Monoclonal, Humanized
• Glucocorticoids
• Vascular Endothelial Growth Factor A
• Bevacizumab
• Triamcinolone Acetonide

Topics

• Adult
• Angiogenesis Inhibitors (administration & dosage)
• Antibodies, Monoclonal (administration & dosage)
• Antibodies, Monoclonal, Humanized
• Bevacizumab
• Female
• Glucocorticoids (administration & dosage)
• Humans
• Injections
• Macular Edema (drug therapy, physiopathology)
• Male
• Pilot Projects
• Retina (pathology)
• Treatment Outcome
• Triamcinolone Acetonide (administration & dosage)
• Uveitis (drug therapy, physiopathology)
• Vascular Endothelial Growth Factor A (antagonists & inhibitors)
• Visual Acuity (physiology)
• Vitreous Body