Diabetik Makula Ödemi Tedavisinde İntravitreal Ranibizumab, Bevacizumab veya Triamsinolon Tedavileri Uygulanan Hastaların Görsel ve Anatomik Sonuçlarının Retrospektif Karşılaştırılması

Abstract

Diabetic retinopathy is the most common reason for visual loss in the working age group and diabetic macular edema is most common associated complication of it leading to visual loss. Here we aimed to compare visual and anatomic outcomes of following intravitral treatments: intravitreal ranibizumab (group 1), bevacizumab (group 2) and triamcinolone (group 3). 275 eyes of 208 patients were enrolled in this retrospective study and main outcome measures were determined as the change in visual acuity (VA) and central macular thickness (CMT). Evaluation of the data at 6 months of treatment compared to initial measurements revealed no significant difference of change in VA in 3 different treatment groups. Mean changes in VA in group 1, group 2 and group 3 were +4,9, +4,3, +4,6 letters, respectively (p=0,911). Similar findings applied to the 24-month results (p=0,306). Improvement of CMT at 6 months was significantly better in group 3, compared to group 1 and 2 and the mean values were -77,9, -74,7, -125,0 μm, in ascending group order (p=0,012). Findings were similar for 24-month outcomes (p=0,001). At the end of 24 months, the only independent variable effecting the change in VA was found to be initial VA, which effected the change inversely (p=0,020). Cataract prevalances in group 1, 2 and 3 were %7,5, %15,3 and %37,3 respectively and it was significantly higher in group 3 (p=0,000). Similarly, glaucoma prevalances were %5,0, %8,9 and %22,6 respectively and was significantly higher in group 3 (p=0,001). As a result, these treatment methods have similar effects with regard to improvement in VA, however, intravitreal triamcinolone provides additional anatomic improvement. One must also consider ocular side effects before opting for a treatment modality.