COMPARATIVE EFFICACY, SAFETY, AND ANATOMICAL OUTCOMES OF INTRAVITREAL TRIAMCINOLONE ACETONIDE VERSUS BEVACIZUMAB IN PATIENTS WITH DIABETIC MACULAR EDEMA: A PROSPECTIVE COMPARATIVE STUDY

Abstract

Diabetic macular edema (DME) is a major cause of visual impairment in patients with diabetic retinopathy. Intravitreal pharmacotherapy, including corticosteroids and anti-vascular endothelial growth factor (anti-VEGF) agents, is an important component of DME treatment. However, comparative data regarding the efficacy and safety of intravitreal triamcinolone acetonide and bevacizumab remain important. In this prospective comparative study, 60 patients with DME were randomly divided into two treatment groups. Group A (n = 30) received intravitreal triamcinolone acetonide (4 mg/0.1 mL), and Group B (n = 30) received intravitreal bevacizumab (1.25 mg/0.05 mL). Best-corrected visual acuity (BCVA), central macular thickness (CMT) measured by spectral-domain optical coherence tomography (SD-OCT), intraocular pressure (IOP), and treatment-related adverse events were assessed at baseline and at 1 week, 1 month, 3 months, and 6 months. Both groups showed statistically significant within-group improvement in BCVA and reduction in CMT over the follow-up period (p < 0.001). The mean reduction in CMT was 169.9 ± 36.5 μm in the triamcinolone group and 146.4 ± 34.8 μm in the bevacizumab group (p = 0.018). Mean visual acuity improvement was also greater in the triamcinolone group (p = 0.014). However, IOP elevation and cataract progression were more frequent in the triamcinolone group, whereas bevacizumab demonstrated a more favorable safety profile. Both intravitreal triamcinolone acetonide and bevacizumab improved anatomical and functional outcomes in patients with DME. In this study, triamcinolone was associated with greater mean reductions in CMT and greater mean visual improvement, but with more frequent ocular adverse effects, particularly increased IOP.