Suprachoroidal steroid in macular edema of diverse etiologies

To compare efficacy and safety of suprachoroidal injection of triamcinolone acetate (SCTA) (1 mg in 0.1 ml) in cases of macular edemas in comparison to intravitreal bevacizumab (IVB)(1.25 mg/ 0.05 ml). Methods: This was a interventional non randomized study conducted in the vitreoretinal department of a tertiary care hospital in Central India for a duration of 6 months. A total of 40 patients were enrolled with macular edema of diverse etilogies. Patients were given suprachoroidal triamcinolone acetate (0.1ml in 4.0ml) and intravitreal bevacizumab (0.05 in 0.1ml).Three monthly injections were given one month apart. The patients were followed for BCVA on day7,1st ,2nd and 3rd month and 1st,2nd and 3rd month for CST. Results: The primary endpoint was non inferiority in BCVA change and reduction in CST from baseline to 12 weeks. At 12 weeks, the SCTA group was non inferior to IVB group. The mean BCVA in SCTA on day 7,1 st month,2nd month and 3rd month were +4letters,+7 letters and 10 letters,13 letters respectively and +4.2 letters,+9 letters,+12 letters and 15 letters respectively in IVB. The mean CST also declined to 60μm, 100μm and 130μm in SCTA group and 40μm,70μm and 110μm group in IVB respectiyely. Minimal adverse effects were encountered in both the groups and were similar. Conclusion: Our study concluded that SCTA was non inferior to IVB in terms of functional and anatomical outcomes. All the eyes had significant anatomic improvement which was at par with intravitreal avastin with low incidence of adverse effects, thus offering a low cost and complication free alternative to anti-VEGF therapy in managing macular edema of diverse etiology.