Erdem Eriş1, Irfan Perente2, Esra Vural3, Aslı Vural4, Zeynep Seymen5, Ali Rıza Cenk Celebi6, Gurkan Erdogan2, Abdullah Ozkaya2, Ozgur Artunay2. 1. Beyoglu Eye Training and Research Hospital, Bereketzade Cami Sok., 34421, Beyoglu, Istanbul, Turkey. erdem-eris@hotmail.com. 2. Beyoglu Eye Training and Research Hospital, Bereketzade Cami Sok., 34421, Beyoglu, Istanbul, Turkey. 3. Department of Ophthalmology, Mardin State Hospital, Mardin, Turkey. 4. Bakırkoy Sadi Konuk Training and Research Hospital, Istanbul, Turkey. 5. Suleymaniye Training and Research Hospital, Istanbul, Turkey. 6. Department of Ophthalmology, School of Medicine, Acıbadem University, Istanbul, Turkey.
Abstract
PURPOSE: To compare sub-tenon steroid plus anti-VEGF injection with anti-VEGF injection solely in the treatment of resistant diabetic macular edema (DME). METHOD: Patients who exhibited insufficient anatomic [over 350 μm central macular thickness (CMT)] and less than 3 lines of visual gain at least six anti-VEGF injections, were randomly divided into two groups. In group I, the anti-VEGF injection was performed 10 days after the sub-tenon steroid injection [Triamcinolone acetonide (Sinakort-A®)]. And anti-VEGF was performed when needed during the follow-up period. In group II, treatment was continued with anti-VEGF only. All patients' visual acuity and CMT were followed up for 6 months. RESULTS: The baseline BCVA in group I and group II was 0.51 ± 0.667 logMAR and 0.47 ± 0.60 logMAR, respectively (p = 0.52). In group I and II, at the end of 6-month follow-up, BCVA improved to 0.38 ± 0.60 logMAR (p < 0.001) and 0.43 ± 0.60 logMAR (p = 0.20), respectively. The baseline CMT in group I and group II was 494 ± 118.32 and 438.20 ± 90.99 μm, respectively (p = 0.029). In group I and II, at the end of 6 months, CMT decreased to 302.57 ± 69.89 μm (p < 0.001) and 439.20 ± 107.6 μm (p = 0.96), respectively. CONCLUSION: Adding steroid to routine anti-VEGF treatment is an effective way of treatment method for resistant DME.
RCT Entities:
PURPOSE: To compare sub-tenon steroid plus anti-VEGF injection with anti-VEGF injection solely in the treatment of resistant diabetic macular edema (DME). METHOD:Patients who exhibited insufficient anatomic [over 350 μm central macular thickness (CMT)] and less than 3 lines of visual gain at least six anti-VEGF injections, were randomly divided into two groups. In group I, the anti-VEGF injection was performed 10 days after the sub-tenon steroid injection [Triamcinolone acetonide (Sinakort-A®)]. And anti-VEGF was performed when needed during the follow-up period. In group II, treatment was continued with anti-VEGF only. All patients' visual acuity and CMT were followed up for 6 months. RESULTS: The baseline BCVA in group I and group II was 0.51 ± 0.667 logMAR and 0.47 ± 0.60 logMAR, respectively (p = 0.52). In group I and II, at the end of 6-month follow-up, BCVA improved to 0.38 ± 0.60 logMAR (p < 0.001) and 0.43 ± 0.60 logMAR (p = 0.20), respectively. The baseline CMT in group I and group II was 494 ± 118.32 and 438.20 ± 90.99 μm, respectively (p = 0.029). In group I and II, at the end of 6 months, CMT decreased to 302.57 ± 69.89 μm (p < 0.001) and 439.20 ± 107.6 μm (p = 0.96), respectively. CONCLUSION: Adding steroid to routine anti-VEGF treatment is an effective way of treatment method for resistant DME.
Authors: Dan Lin; Jiajiang Hu; Ke Wu; Kemi Feng; Xia Zhao; Qingqing Lu; Mingxue Ren; Junlin Cao; Ruru Liu; Mali Dai; Kaihui Nan; Yuqin Wang Journal: Drug Des Devel Ther Date: 2022-04-08 Impact factor: 4.162