Comparision of intravitreal triamsinolone, bevacizumab injection and grid laser photocoagulation treatments in diabetic macular edema

COMPARISON OF INTRAVITREAL TRIAMSINOLONE,BEVACIZUMAB INJECTION AND GRID LASERPHOTOCOAGULATION TREATMENTS IN DIABETICMACULAR EDEMADR. ÜMİ KAPLANTSUMMARYOBJECTIVE: To evaluate the effects of modified grid laserphotocoagulation, intravitreal triamsinolone and intravitreal bevacizumabinjection treatments on visual acuity and regression of edema.MATERIAL AND METHOD: The 90 eyes of 90 patients with diabeticmacular edema were enrolled in the study. The patients were divided intothree groups; 1st group as intravitreal triamsinolone injection group, 2ndgroup as intravitreal bevacizumab injection group, and 3 rd as modified gridlaser photocoagulation group. The differences of mean duration ofdiabetes mellitus, age, and sex of the groups weren?t statisticallysignificant. The patients were followed for three months. The detailedophtalmological examination was done before the treatment, at the 1stweek, 1st month and the 3rd month after the treatment. The correctedvisual acuities were taken. The FFA, Microperimetry and HRT-2 maculamodule measurements were done before the treatment, at the 1st and the3rd months after the treatment.RESULTS: The mean visual acuities for the intravitreal bevacizumabgroup before the treatment, at the 1st week, 1st month and 3rd month were0.199±0.14, 0.228±0.15, 0.242±0.16, 0.264±0.16, respectively. For theintravitreal triamsinolone group, the mean visual acuities were found asbefore the treatment 0.183±0.10, 1st week 0.219±0.14, 1st monthI0.249±0.15, 3rd month 0.279±0.17. The mean visual acuities for themodified grid laser photocoagulation were before the treatment0.337±0.16, 1st week 0.357±0.17, 1st month 0.389±0.19, and 3rd month0.399±0.19. In the 1st and 2nd groups, increase in vision at 1st week and 1stmonth after the treatment were significantly different from the 3rd group(p<0.05). In the 1st group, the difference in central 4 degree mean macularsensitivity at 1st month was significant statistically from baselinemeasurements (p=0.014). The increase in intraocular pressure at 1st week,1st month and 3rd month in group 1 was significantly different from group-2and group-3 (p<0.05). The complications including endophthalmitis,cataract formation, resistant glaucoma and retinal detachment didn?t occurin the injection groups.CONCLUSION: The results of intravitreal bevacizumab injection intreatment of diabetic macular edema were similar to grid laserphotocoagulation and intravitreal triamsinolone acetonide treatments. Thelow incidence of side effects appears to be an advantage for repeatedapplications of this treatment. Multicenter, randomized, controlledinvestigations are required for evaluation of its effects precisely.II