Combined intravitreal bevacizumab and posterior sub-Tenon’s triamcinolone acetonide injections for persistent diabetic macular edema

Abstract

Purpose The aim of this study was to investigate the effect of posterior sub-Tenon’s triamcinolone acetonide injection (PSTI) in conjunction with intravitreal bevacizumab for the treatment of persistent diabetic macular edema (DME). Patients and methods In a prospective, nonrandomized, interventional study, 30 eyes of phakic diabetic patients were diagnosed with persistent DME after being treated with at least two intravitreal bevacizumab injections. Eyes with a residual central macular thickness more than 300 µm were administered PSTI of 40 mg triamcinolone acetonide in conjunction with intravitreal bevacizumab. Best-corrected visual acuity, intraocular pressure, and foveal thickness were measured. Results Significant improvements in the mean central macular thickness measurements were observed at the 1-month and 3-month follow-up visits. Best-corrected visual acuity improvement in eyes with extrafoveal hard exudates (83.3%) was significant at the follow-up intervals of 1 and 3 months, although it was insignificant in eyes with subfoveal hard exudates (16.7%). Conclusion The combined use of intravitreal bevacizumab and PSTI of triamcinolone acetonide was effective in treating persistent DME.

Keywords

• diabetic macular edema
• intravitreal bevacizumab
• optical coherence tomography
• sub-tenon’s injection
• triamcinolone acetonide