Intravitreal Ranibizumab Versus Intravitreal Ranibizumab Combined with Posterior Subtenon Triamcinolone Acetonide in...

Area of Science:

• Ophthalmology
• Retinal Diseases
• Medical Treatments

Background:

• Diabetic macular edema (DME) is a leading cause of vision loss in diabetic patients.
• Intravitreal ranibizumab (IVR) is a common treatment for DME.
• Combination therapies are being explored to enhance DME treatment efficacy.

Purpose of the Study:

• To retrospectively compare the short-term efficacy and safety of intravitreal ranibizumab (IVR) versus IVR combined with posterior subtenon triamcinolone acetonide (STA) for diabetic macular edema (DME).
• To evaluate changes in central macular thickness (CMT) and best-corrected visual acuity (BCVA) post-treatment.
• To analyze treatment outcomes in subgroups, including those with serous retinal detachment (SRD).

Main Methods:

• Retrospective comparative study of 79 pseudophakic eyes from 57 treatment-naive DME patients.
• Group 1 (STA+IVR): Simultaneous STA and IVR, followed by two monthly IVR injections.
• Group 2 (IVR only): Three consecutive monthly IVR injections. Outcomes measured at 1, 2, and 3 months.

Main Results:

• Both IVR and STA+IVR treatments significantly reduced CMT and improved BCVA (p=0.001).
• The combined STA+IVR group showed a statistically significant greater reduction in CMT after the second injection (p=0.017).
• In patients with SRD, the combined group showed a greater mean CMT reduction at 1 month (p=0.048); however, BCVA gains were not significantly different between groups. Increased need for anti-glaucomatous treatment in the combined group (p=0.008).

Conclusions:

• Both IVR and combined STA+IVR are effective treatments for improving BCVA and CMT in DME.
• The combination therapy demonstrated a potential anatomical advantage in reducing macular thickness, particularly in the early stages and in patients with SRD.
• Further research may be warranted to balance efficacy with potential side effects like increased intraocular pressure.