Ramyash Singh Yadav1, Ram Kumar Jaiswal2, Punita Tripathi3, Mridula Ranjan4, Chiranji Rai5
BACKGROUND
Diabetic macular oedema is a sight threatening complication of diabetic
retinopathy. Vascular endothelial growth factor (VEGF) plays an important role in
developing diabetic macular oedema. There are many treatment options available
for diabetic macular oedema such as laser therapy, intravitreal injectable
medications like anti-VEGF and steroids. This study intends to compare the efficacy
and safety of intravitreal injection Ranibizumab (anti-VEGF) and Triamcinolone
acetonide (steroid) in diabetic macular oedema.
METHODS
This is a prospective randomized study conducted among 42 patients ≥ 18 years
of age with diabetic macular oedema presenting to outpatient department in a
tertiary care centre in Gorakhpur, UP, conducted from November 2019 – December
2020. 42 participating patients were divided into 2 groups, A and B with 21 patients
in each group. Group A treated with intravitreal injection Ranibizumab (0.05 ml ;
0.50 mg) and group B treated with intravitreal injection Triamcinolone acetonide
(4 mg in 0.1 ml). All patients were followed-up at 2 week and 4 week after injection
for best corrected visual acuity, intraocular pressure, foveal and para-foveal
thickness. Optical coherence tomography was performed for measuring foveal and
para-foveal thickness.
RESULTS
The mean age group being 56.48 years in group A and 58.63 years in group B
with 12 male and 9 female patients in group A and 10 male and 11 female patients
in group B with no dropout during study period. Both injections were equally
effective in reducing foveal and para-foveal thickness and improving best
corrected visual acuity. Intraocular pressure (IOP) was stable in Ranibizumab
treated group but Triamcinolone treated group showed raised IOP in few patients,
required anti-glaucoma medications.
CONCLUSIONS
Both treatment types had good efficacy in reducing foveal and para-foveal
thickness and thus improving best corrected visual acuity, but intravitreal
Ranibizumab is safer and well tolerated along with good efficacy in patients with
diabetic macular oedema.
