Intravitreal Bevacizumab Versus Triamcinolone Acetonide for Refractory Uveitic Cystoid Macular Edema: A Randomized Pilot Study

Abstract

Purpose: To compare intravitreal bevacizumab (IVB) versus intravitreal triamcinolone acetonide (IVT) for treatment of refractory uveitic cystoid macular edema (CME). Methods: In this randomized clinical trial, 31 eyes with uveitic CME were allocated into the IVB group—eyes that received 1–3 injections of 1.25 mg bevacizumab (15 eyes) and the IVT group—eyes that received 1–3 injections of 2 mg triamcinolone (16 eyes). Primary outcome measure was change in best-corrected visual acuity (VA) at 36 weeks. Results: Visual acuity improvement compared with baseline values was meaningful in the IVB group at 12, 24, and 36 weeks (−0.35 ± 0.45 logMAR [P = 0.016]) and in the IVT group at 24 and 36 weeks (−0.32 ± 0.32 logMAR [P = 0.001]). A significant central macular thickness (CMT) reduction was observed only in the IVT group at week 36 (74.6 ± 108.0 μm [P = 0.049]). Between-group analysis disclosed no significant difference in any outcome measure. By statistically removing the factor of cataract, the IVT group had more improvement in VA (P = 0.007). Conclusions: IVB was as effective as IVT in refractory uveitic CME regarding VA improvement up to 36 weeks. Irrespective of triamcinolone-induced cataract, a more beneficial effect of IVT may be attainable.