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Intravitreal diclofenac versus intravitreal bevacizumab in persistent diabetic macular edema: Anatomical and functional outcome

PURPOSE: To compare the efficacy of diclofenac versus bevacizumab following single intravitreal injection in eyes with persistent diabetic macular edema. METHODS: Fifty eyes with persistent DME were randomly allocated to intravitreal injection of 500 µg/0.1 ml of diclofenac (N = 20) or 1.25 mg/0.05 ...

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Autores principales: ElBendary, Amal, Elkannishy, Amr H.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6300766/
https://www.ncbi.nlm.nih.gov/pubmed/30581301
http://dx.doi.org/10.1016/j.sjopt.2018.10.003
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author ElBendary, Amal
Elkannishy, Amr H.
author_facet ElBendary, Amal
Elkannishy, Amr H.
author_sort ElBendary, Amal
collection PubMed
description PURPOSE: To compare the efficacy of diclofenac versus bevacizumab following single intravitreal injection in eyes with persistent diabetic macular edema. METHODS: Fifty eyes with persistent DME were randomly allocated to intravitreal injection of 500 µg/0.1 ml of diclofenac (N = 20) or 1.25 mg/0.05 mL of bevacizumab (N = 20) or to non-treatment (10 eyes). Preoperative and postoperative visual acuity, central, paracentral macular thickness and intraocular pressure (IOP) were recorded and compared between the three groups up to 4 weeks. RESULTS: Diclofenac and bevacizumab groups showed statistically significant reduction in central and paracentral macular thickness (diclofenac: p = 0.006, 0.02 and bevacizumab: p = 0.02, 0.01), without statistically significant difference between the two groups. The two groups showed no statistically significant difference in mean visual acuity or mean line improvement. Mean visual acuity improvement didn't reach statistical significance in either group. Diclofenac group showed statistically significant reduced IOP (P = 0.02). Control eyes did not show any change in mean visual acuity, macular thickness or IOP. CONCLUSION: In persistent DME, diclofenac has a structural effect comparable to bevacizumab on central macular thickness. However, significant functional gain may not be accomplished by single injection. Unlike naïve DME, persistent cases may be confounded by systemic and local factors necessitating repeated injection of diclofenac.
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spelling pubmed-63007662018-12-21 Intravitreal diclofenac versus intravitreal bevacizumab in persistent diabetic macular edema: Anatomical and functional outcome ElBendary, Amal Elkannishy, Amr H. Saudi J Ophthalmol Original Article PURPOSE: To compare the efficacy of diclofenac versus bevacizumab following single intravitreal injection in eyes with persistent diabetic macular edema. METHODS: Fifty eyes with persistent DME were randomly allocated to intravitreal injection of 500 µg/0.1 ml of diclofenac (N = 20) or 1.25 mg/0.05 mL of bevacizumab (N = 20) or to non-treatment (10 eyes). Preoperative and postoperative visual acuity, central, paracentral macular thickness and intraocular pressure (IOP) were recorded and compared between the three groups up to 4 weeks. RESULTS: Diclofenac and bevacizumab groups showed statistically significant reduction in central and paracentral macular thickness (diclofenac: p = 0.006, 0.02 and bevacizumab: p = 0.02, 0.01), without statistically significant difference between the two groups. The two groups showed no statistically significant difference in mean visual acuity or mean line improvement. Mean visual acuity improvement didn't reach statistical significance in either group. Diclofenac group showed statistically significant reduced IOP (P = 0.02). Control eyes did not show any change in mean visual acuity, macular thickness or IOP. CONCLUSION: In persistent DME, diclofenac has a structural effect comparable to bevacizumab on central macular thickness. However, significant functional gain may not be accomplished by single injection. Unlike naïve DME, persistent cases may be confounded by systemic and local factors necessitating repeated injection of diclofenac. Elsevier 2018 2018-10-13 /pmc/articles/PMC6300766/ /pubmed/30581301 http://dx.doi.org/10.1016/j.sjopt.2018.10.003 Text en © 2018 The Authors http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Original Article
ElBendary, Amal
Elkannishy, Amr H.
Intravitreal diclofenac versus intravitreal bevacizumab in persistent diabetic macular edema: Anatomical and functional outcome
title Intravitreal diclofenac versus intravitreal bevacizumab in persistent diabetic macular edema: Anatomical and functional outcome
title_full Intravitreal diclofenac versus intravitreal bevacizumab in persistent diabetic macular edema: Anatomical and functional outcome
title_fullStr Intravitreal diclofenac versus intravitreal bevacizumab in persistent diabetic macular edema: Anatomical and functional outcome
title_full_unstemmed Intravitreal diclofenac versus intravitreal bevacizumab in persistent diabetic macular edema: Anatomical and functional outcome
title_short Intravitreal diclofenac versus intravitreal bevacizumab in persistent diabetic macular edema: Anatomical and functional outcome
title_sort intravitreal diclofenac versus intravitreal bevacizumab in persistent diabetic macular edema: anatomical and functional outcome
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6300766/
https://www.ncbi.nlm.nih.gov/pubmed/30581301
http://dx.doi.org/10.1016/j.sjopt.2018.10.003
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