Comparison of Suprachoroidal Triamcinolone Injection with Intravitreal Bevacizumab Vs Intravitreal Bevacizumab only in Treatment of Refractory Diabetic Macular Edema

Shahid, Muhammad Hamza; Rashid, Faisal; Tauqeer, Saba; Ali, Rabab; Farooq, Muhammad; Aleem, Nouman

doi:10.53350/pjmhs22166301

Cited by 2 publications

(1 citation statement)

References 12 publications

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“…They also determined that SCTA with IV Bevacizumab was more effective in reducing CMT compared to IV Bevacizumab alone. However, BCVA changes were not directly assessed in this study, which assumed a correlation between CMT decline and BCVA improvements based on other trials [ 105 ]. After randomly assigning 136 participants to receive either SCTA or IV Bevacizumab, Anwar and colleagues (2022) determined that a single dose of SCTA resulted in greater improvements in visual acuity and a more significant reduction in CMT [ 106 ].…”

Section: Suprachoroidal Injection In Ocular Diseasesmentioning

confidence: 99%

Suprachoroidal Injection: A Novel Approach for Targeted Drug Delivery

Wu,

Fujioka,

Gholamian

et al. 2023

Pharmaceuticals

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Treating posterior segment and retinal diseases poses challenges due to the complex structures in the eye that act as robust barriers, limiting medication delivery and bioavailability. This necessitates frequent dosing, typically via eye drops or intravitreal injections, to manage diseases, often leading to side effects with long-term use. Suprachoroidal injection is a novel approach for targeted drug delivery to the posterior segment. The suprachoroidal space is the region between the sclera and the choroid and provides a potential route for minimally invasive medication delivery. Through a more targeted delivery to the posterior segment, this method offers advantages over other routes of administration, such as higher drug concentrations, increased bioavailability, and prolonged duration of action. Additionally, this approach minimizes the risk of corticosteroid-related adverse events such as cataracts and intraocular pressure elevation via compartmentalization. This review focuses on preclinical and clinical studies published between 2019 and 2023, highlighting the potential of suprachoroidal injection in treating a variety of posterior segment diseases. However, to fully harness its potential, more research is needed to address current challenges and limitations, such as the need for technological advancements, refinement of injection techniques, and consideration of cost and accessibility factors. Future studies exploring its use in conjunction with biotech products, gene therapies, and cell-based therapies can lead to personalized treatments that can revolutionize the field of ophthalmology.

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Section: Suprachoroidal Injection In Ocular Diseasesmentioning

confidence: 99%

Suprachoroidal Injection: A Novel Approach for Targeted Drug Delivery

Wu,

Fujioka,

Gholamian

et al. 2023

Pharmaceuticals

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Anti-Vascular Endothelial Growth Factor Combined with Ocular Steroid Therapy for Persistent Diabetic Macular Edema: A Systematic Review and Meta-Analysis

Ma,

Tao,

Yuan

et al. 2024

Pharmaceuticals

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Purpose: Our purpose was to appraise the efficacy and safety of intravitreous vascular endothelial growth factor inhibitor (anti-VEGF) therapy combined with steroids for persistent diabetic macular edema. Methods: A systematic review was conducted of the research evaluating the combination therapy of anti-VEGF and steroids for persistent diabetic macular edema compared to anti-VEGF alone. A meta-analysis was performed using a protocol registered in PROSPERO (CRD42023476333). Continuous and binary variables were extracted. Results were expressed as the mean difference (MD) and risk ratio (RR). Results: A total of 9 trials with 537 eyes were included. The MDs of improvement in best-corrected visual acuity (BCVA) at 1/2/3/6/9/12 months between the combined and monotherapy groups were 1.33 (95% CI [−1.31,3.96]), 3.03 (95% CI [0.01, 6.06]), −0.37 (95% CI [−4.74, 4.00]), −1.37 (95% CI [−4.65, 1.91]), 1.05 (95% CI [−3.68, 5.77]), and 1.70 (95% CI [−3.52, 6.93]). The MDs concerned with a central retinal thickness (CMT) decline in at 1/2/3/6/9/12 months between the two groups were −47.33, 95% CI [−94.35, −0.32]), −89.19 (95% CI [−114.38, −64.00]), −58.84 (95% CI [−96.93, −20.74]), −57.23 (95% CI [−102.62, −11.84]), −40.59 (95% CI [−80.59, −0.58]), and −38.89 (95% CI [−77.38, −0.40]), respectively. Furthermore, the combined group obtained higher relative risks of experiencing events with high intraocular pressure and progressed cataracts. Conclusions: Anti-VEGF combined with ocular steroids showed a significant advantage in improving the retinal anatomical structure compared to anti-VEGF monotherapy for persistent diabetic macular edema. However, as the treatment period extended, the combination treatment was no more effective than monotherapy after 2 months, with more severe side effects.

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Comparison of Suprachoroidal Triamcinolone Injection with Intravitreal Bevacizumab Vs Intravitreal Bevacizumab only in Treatment of Refractory Diabetic Macular Edema

Cited by 2 publications

References 12 publications

Suprachoroidal Injection: A Novel Approach for Targeted Drug Delivery

Suprachoroidal Injection: A Novel Approach for Targeted Drug Delivery

Anti-Vascular Endothelial Growth Factor Combined with Ocular Steroid Therapy for Persistent Diabetic Macular Edema: A Systematic Review and Meta-Analysis

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