Qiangqiang GUO, Xin ZHANG, Yi DONG, Yunzhuo BIAN, Lei WANG, Jiao WANG
Annals of Clinical and Analytical Medicine - 2026;17(6):611-616
Aim: To investigate the effects of intravitreal injection of triamcinolone acetonide (TA) and bevacizumab(BEV) on ophthalmic artery (OA), central retinal artery (CRA), nasal posterior ciliary artery (NPCA), temporal posterior ciliary artery (TPCA), VEGF, IL-6 levels, and other factors in patients with refractory diabetic macular edema (DME). Methods: In this randomized double-blind trial, 80 refractory DME patients (mean disease duration: 5.2 years) were assigned to: Control group (n = 40): 4mg TA monotherapy; Combination group (n = 40): 1.25mg BEV + 2mg TA. Intervention: Monthly injections x3. Primary outcomes included peak systolic velocity (PSV) and aqueous humor biomarkers (ELISA). Secondary outcomes encompassed best-corrected visual acuity (LogMAR), central macular thickness (CMT), and adverse events. Results: Compared with TA alone, the combination of TA and BEV significantly decreased the levels of VEGF and IL-6, and increased the blood flow of OA, CRA, NPCA and TPCA and the levels of NOS. In addition, the combination therapy also improved best corrected visual acuity (BCVA), reduced retinal thickness, and reduced the incidence of complications such as anterior chamber inflammation, hypopyon, corneal edema, and elevated intraocular pressure. Conclusion: TA combined with BEV in the treatment of refractory DME can significantly improve the blood flow parameters of ocular blood vessels, reduce the level of VEGF, so as to effectively reduce macular edema and improve the vision of patients. Compared with TA alone, combination therapy may have more significant efficacy and better safety.
