Both anti-VEGF injections and posterior subtenon TA injections were effective at slowing DME progression.

Both anti-VEGF injections and posterior subtenon TA injections were effective at slowing DME progression. Click image to enlarge.

Both posterior sub-Tenon triamcinolone acetonide (TA) injections and intravitreal anti-VEGF injections during cataract surgery have demonstrated efficacy in preventing the progression of diabetic macular edema (DME). In a recently published study, researchers compared the two approaches retrospectively to assess their ability to prevent progression in diabetic patients. They reported that both treatments are effective.

The study included 73 eyes of 65 DME patients, all with central macular thicknesses (CMT) greater than or equal to 300µm. Eyes included in the study received phacoemulsification with intravitreal ranibizumab injection, phacoemulsification with subtenon TA injection or phacoemulsification only. The researchers assessed BCVA and compared pre- and post-op CMT.

At one month, the researchers reported a statistically “substantial distinction” in median CMT between the ranibizumab and control groups, the subtenon TA and control groups and the ranibizumab and subtenon TA groups. Three months later, the researchers noted “considerable variance” between the ranibizumab and control groups and the subtenon TA and control groups.

“This work showed that intravitreal ranibizumab injection at the time of cataract surgery caused a significant decrease in macular thickness as compared with the other groups,” the researchers wrote in their paper. “CMT was significantly decreased in the subtenon TA group, as compared with the control group, which was directly reflected in the improvement in VA.”

They concluded that both approaches may decrease CMT and improve BCVA with “relatively better significant results in the intravitreal ranibizumab injection after surgery.”

Khalil M, Mansour H, Tawfik A, et al. Comparison between intravitreal ranibizumab injection and posterior subtenon triamcinolone acetonide injection at time of cataract surgery for prevention of progression of diabetic macular edema. BMC Ophthalmol. 2022;22(1):492.