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首页> 外文期刊>American Journal of Ophthalmology: The International Journal of Ophthalmology >Comparative therapy evaluation of intravitreal bevacizumab and triamcinolone acetonide on persistent diffuse diabetic macular edema.
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Comparative therapy evaluation of intravitreal bevacizumab and triamcinolone acetonide on persistent diffuse diabetic macular edema.

机译：玻璃体内贝伐单抗和曲安奈德治疗持续性弥漫性糖尿病性黄斑水肿的对比治疗评价。

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PURPOSE: To compare the effect of an intravitreal injection of bevacizumab, an anti-vascular endothelial growth factor (VEGF) antibody, with that of triamcinolone acetonide, a corticosteroid for reduction of diabetic macular edema (DME). DESIGN: Prospective, comparative interventional case series. METHODS: Twenty-eight eyes of 14 patients with bilateral DME participated in this study. In each patient, one eye received an intravitreal injection of 4 mg triamcinolone acetonide and the other eye received 1.25 mg bevacizumab. The clinical course of best-corrected visual acuity (VA) with a logarithm of the minimum angle of resolution chart and averaged foveal thickness using optical coherence tomography was monitored for up to 24 weeks after the injection. RESULTS: Before the injection, foveal thickness and VA were 522.3 +/- 91.3 microm and 0.64 +/- 0.28 microm in the triamcinolone-injected eye, and 527.6 +/- 78.8 microm and 0.61 +/- 0.18 microm in the bevacizumab-injected eye, respectively; there was no significant difference between the eyes. One week after the injection, both eyes showed significant regression of macular edema. The triamcinolone-injected eye (342.6 +/- 85.5 microm and 0.33 +/- 0.21 microm) showed significantly better results than the bevacizumab-injected eye (397.6 +/- 103.0 microm and 0.37 +/- 0.17 microm). However, both eyes showed the recurrence of macular edema with time, even at 24 weeks. Triamcinolone (410.4 +/- 82.4 microm and 0.47 +/- 0.25 microm) kept better results than bevacizumab (501.6 +/- 92.5 microm and 0.61 +/- 0.17 microm). CONCLUSIONS: With the generally used concentration, intravitreal injection of triamcinolone acetonide showed better results in reducing DME and in the improvement of VA than that of bevacizumab, suggesting that the pathogenesis of DME is not only attributable to VEGF-dependency, but is also attributable to other mechanisms suppressed by corticosteroid.
机译：目的：比较玻璃体内注射抗血管内皮生长因子（VEGF）抗体贝伐单抗与糖皮质激素曲安奈德的效果，该糖皮质激素可降低糖尿病性黄斑水肿（DME）。设计：前瞻性，比较性介入病例系列。方法：14例双侧DME患者的28只眼参与了这项研究。在每位患者中，一只眼接受玻璃体内注射4 mg曲安奈德，另一只眼接受1.25 mg贝伐单抗。在注射后长达24周的时间内，对最佳矫正视力（VA）的临床过程进行了监测，该过程以最小分辨角图的对数和平均中央凹厚度使用光学相干断层扫描进行对数。结果：注射前，经曲安奈德注射的眼的中央凹厚度和VA分别为522.3 +/- 91.3微米和0.64 +/- 0.28微米，注射贝伐单抗的中央凹厚度和VA为527.6 +/- 78.8微米和0.61 +/- 0.18微米眼睛眼睛之间没有显着差异。注射后一周，两只眼睛均显示出黄斑水肿的明显消退。注射曲安西龙的眼（342.6 +/- 85.5微米和0.33 +/- 0.21微米）比注射贝伐单抗的眼（397.6 +/- 103.0微米和0.37 +/- 0.17微米）显示出明显更好的结果。然而，即使在24周时，两只眼睛都显示出随着时间的推移黄斑水肿的复发。曲安西龙（410.4 +/- 82.4微米和0.47 +/- 0.25微米）比贝伐单抗（501.6 +/- 92.5微米和0.61 +/- 0.17微米）保持更好的结果。结论：在通常使用的浓度下，玻璃体内注射曲安奈德比贝伐单抗在减少DME和改善VA方面显示出更好的结果，表明DME的发病机理不仅归因于VEGF依赖性，而且还归因于其他机制被皮质类固醇抑制。

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