Randomized trial evaluating short-term effects of intravitreal ranibizumab or triamcinolone acetonide on macular edema after focal/grid laser for diabetic macular edema in eyes also receiving panretinal photocoagulation.

Journal Article (Clinical Trial, Phase III;Journal Article;Multicenter Study)

PURPOSE: To evaluate 14-week effects of intravitreal ranibizumab or triamcinolone in eyes receiving focal/grid laser for diabetic macular edema and panretinal photocoagulation. METHODS: Three hundred and forty-five eyes with a visual acuity of 20/320 or better, center-involved diabetic macular edema receiving focal/grid laser, and diabetic retinopathy receiving prompt panretinal photocoagulation were randomly assigned to sham (n = 123), 0.5-mg ranibizumab (n = 113) at baseline and 4 weeks, and 4-mg triamcinolone at baseline and sham at 4 weeks (n = 109). Treatment was at investigator discretion from 14 weeks to 56 weeks. RESULTS: Mean changes (±SD) in visual acuity letter score from baseline were significantly better in the ranibizumab (+1 ± 11; P < 0.001) and triamcinolone (+2 ± 11; P < 0.001) groups compared with those in the sham group (-4 ± 14) at the 14-week visit, mirroring retinal thickening results. These differences were not maintained when study participants were followed for 56 weeks for safety outcomes. One eye (0.9%; 95% confidence interval, 0.02%-4.7%) developed endophthalmitis after receiving ranibizumab. Cerebrovascular/cardiovascular events occurred in 4%, 7%, and 3% of the sham, ranibizumab, and triamcinolone groups, respectively. CONCLUSION: The addition of 1 intravitreal triamcinolone injection or 2 intravitreal ranibizumab injections in eyes receiving focal/grid laser for diabetic macular edema and panretinal photocoagulation is associated with better visual acuity and decreased macular edema by 14 weeks. Whether continued long-term intravitreal treatment is beneficial cannot be determined from this study.

Full Text

Duke Authors

Cited Authors

  • Diabetic Retinopathy Clinical Research Network, ; Googe, J; Brucker, AJ; Bressler, NM; Qin, H; Aiello, LP; Antoszyk, A; Beck, RW; Bressler, SB; Ferris, FL; Glassman, AR; Marcus, D; Stockdale, CR

Published Date

  • June 2011

Published In

Volume / Issue

  • 31 / 6

Start / End Page

  • 1009 - 1027

PubMed ID

  • 21394052

Pubmed Central ID

  • PMC3489032

Electronic International Standard Serial Number (EISSN)

  • 1539-2864

Digital Object Identifier (DOI)

  • 10.1097/IAE.0b013e318217d739


  • eng

Conference Location

  • United States