الفهرس 
? Anatomy of the maculaOnly 14 pages are availabe for public view
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Abstract
n this study, we compared three types of intravitreal injections for the treatment of DME. Group A received 4mg/0.1ml intravitreal triamcinolone acetonide, group B received 1.25mg/0.05ml intravitreal bevacizumab, and group C received 1.25mg/0.05ml intravitreal bevacizumab followed by 4mg/0.1ml intravitreal triamcinolone acetonide after 1 week. We had 3 follow up visits; 1 week, 1 month and 3 months.
Improvement in central macular thickness and visual acuity was seen from the first week, and reached its maximum after 1 month in all the study groups.
On comparing the improvement of the 3 study groups, we found that the first and the third groups showed better improvement in all the follow up period as regards the reduction in macular thickness and improvement of visual acuity.
The 3 months follow up period showed stability of the improvement that occurred in the triamcinolone and the combined groups, which was almost equal in these two groups, while regression was seen in the bevacizumab group.
However, intravitreal triamcinolone acetonide has its complications. The most common risk associated with intravitreal injection of steroids is elevated intraocular pressure which occurred in 24% in the triamcinolone group and in 32% in the combined groups respectively.
The second most common complication of intravitreal triamcinolone acetonide is the development of cataract, which occurred only in 1 eye in the triamcinolone group and 1 eye in the combined group.
The most serious complication is endophthalmitis, but fortunately it did not occur in any of the patients of this study.
So we believe that intravitreal triamcinolone acetonide have better effect in reducing severe diabetic macular edema and improving visual acuity than intravitreal bevacizumab, and that combining intravitreal bevacizumab with intravitreal triamcinolone has no additive effect on triamcinolne. Intravitreal bevacizumab alone may have a better effect in moderate diabetic macular edema, especially if repeated injections are given.