Combined therapy in diabetic macular edema

SummaryPurposeTo determine the effectiveness of three different combinations for the “loading phase” in the treatment of diabetic macular edema (DME), using bevacizumab (BVZ), triamcinolone (TCL) and subthreshold macular photocoagulation (SMPC).MethodsExperimental, longitudinal, prospective, comparative and blind. Patients were randomly assigned to three treatment branches: Group 1: BVZ+SMPC (12 eyes), Group 2: SMPC+BVZ+TCL (7 eyes), Group 3: BVZ+TCL (11 eyes). Treatment with BVZ and TCL was given every 4 weeks for 3 months, SMPC was applied once at the beginning of treatment. Initial and final measurements of best corrected visual acuity (BCVA), central macular thickness (CMT) and intraocular pressure (IOP) were tested.ResultsThe improvement in BCVA and the reduction in CMT was statistically superior in group of BVZ+SMPCwhen compared to the other groups. There were no differences in IOP.ConclusionsCombined therapies in the “loading phase”are a good option when treating DME. Although the group with BVZ+SMPC obtained the best results, further studies with longer follow-up and a higher number of participants to establish this combined therapy as the first treatment option are required