| Objective. To compare an intravitreal high-dose injection of triamcinolone acetonide versus an intravitreal injection of bevacizumab for treatment of progressive exudative age-related macular degeneration (AMD).
Design. Comparative non-randomized retrospective clinical interventional study
Participants. The study included 305 patients with progressive AMD, divided into a bevacizumab group of 36 patients (1.5 mg bevacizumab) and a triamcinolone group of 269 patients (about 20 mg triamcinolone). All patients were consecutively included, in the first phase of the study for triamcinolone, and in the second phase of the study for bevacizumab. Mean follow-up was 8.5 ± 6.8 months (2-35.7 months).
Methods. Intravitreal injection of triamcinolone (about 20 mg) or bevacizumab (1.5 mg).
Main Outcome Measure. Visual acuity, intraocular pressure.
Results. In the bevacizumab group, best visual acuity increased significantly (P<0.001) by 3.2 ± 3.4 Snellen lines or -0.31 ± 0.33 logMAR, with 25 (69%) eyes and 21 (58%) eyes, respectively, improving by at least 2 Snellen lines and 3 lines, respectively. Increase in visual acuity was significant for the measurements taken at two months after the injection (P<0.001). In the triamcinolone group, best visual acuity increased significantly (P<0.001) by 0.87 ± 2.88 Snellen lines or–0.09 ± 0.31 logMAR, with 95 (35%) eyes and 59 (22%) eyes, respectively, improving by at least 2 Snellen lines and 3 lines, respectively. The visual acuity change was not statistically significant for any specific follow-up examination within the first 3 months. Comparing the bevacizumab group with the triamcinolone group, the maximal increase in visual acuity was significantly (P<0.001) higher in the bevacizumab group. The same held true for the comparison of the visual acuity change at 2 months after the injection (P<0.001). Correspondingly, the percentage of patients with an visual acuity improvement by at least 2 Snellen lines and 3 lines, respectively, was significantly (P<0.001) higher in the bevacizumab group. Intraocular pressure increased significantly (p<0.001) in the triamcinolone group, and did not change significantly (P=0.47) in the bevacizumab group.
Conclusions. In exudative age-related macular degeneration, intravitreal bevacizumab (1.5mg) compared with intravitreal triamcinolone acetonide (about 20mg) results in a higher improvement of visual acuity and does not markedly influence intraocular pressure within 2 months after injection.
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