To compare short term visual and anatomical outcomes of single intravitreal injection of triamcinolone acetonide (4 mg/0.1 ml) versus single intravitreal injection of bevacizumab (1.25 mg/0.05 ml) in diabetic macular edema at the end of one month

Purpose:To compare the short-term efficacy and safety of intravitreal bevacizumab (IVB) versus intravitreal triamcinolone acetonide (IVTA) in the management of diabetic macular edema (DME). Methods:A randomized, comparative, interventional study was conducted on 40 eyes of patients with DME, divided equally into two groups (n=20 each). Group 1 received 1.25 mg/0.05 mL IVB, while Group 2 received 4 mg/0.1 mL IVTA. Baseline characteristics, including age, sex, duration of diabetes, best corrected visual acuity (BCVA), and central macular thickness (CMT), were comparable between the groups. BCVA (logMAR) and CMT were assessed at baseline and at 1 month post-injection. Results:At 1 month, both groups demonstrated statistically significant improvement in BCVA and CMT compared to baseline (p < 0.0475). The IVTA group showed significantly greater improvement in BCVA (p = 0.0074) and a larger reduction in CMT compared to the IVB group. A statistically significant increase in intraocular pressure (IOP) was observed in the IVTA group at 1 month, with 3 eyes (15%) exhibiting an elevation of ≥4 mmHg from baseline, which was managed successfully with topical anti-glaucoma medications. No other complications were recorded in either group. Conclusion:A single intravitreal injection of triamcinolone acetonide produces superior short-term improvements in visual acuity and macular thickness compared to bevacizumab in patients with DME. However, the associated risk of IOP elevation with IVTA requires careful post-injection monitoring.