ArticleOphthalmology and therapy2025
Revisiting the Role of Intravitreal Triamcinolone in Diabetic Macular Edema: 12-Month Outcomes after Bevacizumab Failure.
Article in Ophthalmology and therapy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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5 authors.
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Abstract
introductionRefractory diabetic macular edema (DME) is challenging in resource-limited settings, where costly alternatives such as non-bevacizumab anti-vascular endothelial growth factors (VEGFs) and corticosteroid implants are inaccessible. In Thailand, budget constraints exclude these drugs from healthcare schemes covering 92% of the population, a common issue in developing Asian countries. Therefore, this study aimed to evaluate the treatment outcome of repeated intravitreal triamcinolone acetonide (IVTA) dosages for DME refractory to intravitreal bevacizumab over a 12-month period using a decision algorithm.
methodsThis was a comparative retrospective study. The included patients were randomly divided into two groups that received either 2 mg or 4 mg IVTA, following a decision algorithm. The primary outcome was the difference in central macular thickness (CMT) between the 2 mg IVTA and 4 mg IVTA groups at 6-month and 12-month follow-up visits.
resultsOverall, 81 eyes (62 patients) with DME refractory to bevacizumab were enrolled. The study involved 53 eyes (37 cases) divided into two groups: group 1 (2 mg IVTA) of 14 eyes, and group 2 (4 mg IVTA) of 39 eyes. The 4 mg IVTA group had a higher initial CMT than their 2 mg IVTA counterparts (P = 0.02). This difference disappeared after 6 and 12 months. The improvement in CMT in both groups was maintained across the 6- and 12-month follow-up periods compared with baseline. Univariate logistic regression analysis revealed that patients with thinner CMT before IVTA treatment had a greater probability of being DME-free over long-term follow-up.
conclusionsRepeated IVTA treatments for DME refractory to bevacizumab over a 12-month period demonstrated efficacy and appeared to have a comparable safety profile. Patients with thinner CMT before IVTA treatment had a greater probability of remaining DME-free after IVTA treatment.
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