Short-Term Outcomes of Intravitreal Brolucizumab Injection and Sub-Tenon Injection of Triamcinolone Acetonide for...

Purpose: To evaluate the short-term efficacy and safety of intravitreal brolucizumab combined with sub-Tenon triamcinolone acetonide in treating diabetic macular edema (DME). Methods: Medical records were retrospectively reviewed for 11 patients with DME (14 eyes) treated with intravitreal brolucizumab and sub-Tenon triamcinolone acetonide injections at our hospital using a 1 + pro re nata injection regimen. Data collected included best-corrected visual acuity (BCVA), central macular thickness (CMT), injection frequency, and adverse events. Patients were followed up for at least 6 months. Results: At baseline, the mean BCVA was 0.43 logMAR, and the mean CMT was 418.4 µm. After 1 month of treatment, BCVA improved, and CMT significantly decreased in all cases. These improvements were maintained over 6 months of treatment, with a mean injection frequency of 1.14 injections over 6 months. This combination therapy was effective both in patients who were treatment naïve at baseline and in those who were previously treated with an anti-vascular endothelial growth factor agent. No significant complications, such as intraocular inflammation or elevated intraocular pressure, were observed during follow-up. Conclusions: Combination therapy with intravitreal brolucizumab and sub-Tenon triamcinolone acetonide may offer anatomic benefits in patients with DME, requiring fewer injections. Further evaluation using larger, prospectively designed studies is warranted to confirm its functional efficacy and long-term safety.