This prospective randomised interventional clinical trial compared 30 diabetic patients with macular oedema treated with either intravitreal injections of bevacizumab (Avastin) or triamcinolone (Volon A). One group initially received three injections of 2.5 mg Avastin in monthly intervals whilst the second group received a single injection of 8mg Volon A, followed by two sham interventions. Functional and anatomic results were evaluated monthly using ETDRS vision charts and spectral-domain optical coherence tomography. Retreatment after three months was dependent on functional and anatomic outcome. The results showed baseline best corrected visual acuity (BCVA) was 0.30 logMAR and central retinal subfield thickness was 505µm in the Avastin group and 0.32logMAR and 490µm in the Volon A group. After three months, visual acuity improved to 0.23 logMAR (Avastin) and retinal thickness to 358µm and 0.26 logMAR (Volon A) and 308µm. After 12 months, visual acuity further recovered in the Avastin group (0.18 logMAR) but slightly decreased in the Volon A group (0.36 logMAR). Both treatments were effective in the early stages of the disease but after one year BCVA was better in the Avastin group. The authors discuss risk factors and patient selection should be taken into account when selecting appropriate treatment.

Intravitreal bevacizumab (avastin) versus triamcinolone (Volon A) for diabetic treatment of diabetic macular edema: one-year results.
Kriechbaum K, Prager S, Mylonas G, et al.
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Nana Theodorou

BMedSCi (Hons) PhD, Sheffield Teaching Hospitals NHS Foundation Trust, Clinical Research Office, 11 Broomfield Road, Sheffield, S10 2SE, UK.

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