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Abstract：
BACKGROUND: Previous studies have shown promising effects of combining intravitreal bevacizumab and suprachoroidal injection of triamcinolone acetonide in treating DME. However, further research is needed.
OBJECTIVE: To assess the efficacy and safety of combining both intravitreal Ziv-aflibercept and suprachoroidal injection of triamcinolone acetonide using a custom-made needle in naïve and de novo central diabetic macular edema (DME) patients every eight weeks for 24 weeks.
METHODS: Central macular thickness was measured via spectral domain-optical coherence tomography, and best-corrected visual acuity was measured via a Snellen chart at baseline and at 4, 8, 12, 16, and 24 weeks postinjection. Additionally, cataract progression, intraocular pressure (IOP), and ocular safety were analyzed.
RESULTS: A total of 10 eyes of 6 patients were treated with suprachoroidal injections of triamcinolone acteonid combined with an intravitreal injection of Ziv-aflibercept. Vision improved from 0.69 log minimum angle of resolution (MAR) at baseline to 0.39 log MAR after treatment. Central macular thickness significantly decreased from 462.3 ± 166 μm at baseline to 362.7 ± 77.6 μm at 24 weeks postinjection.
CONCLUSIONS: Suprachoroidal injection of triamcinolone using a custom-made needle with the intravitreal agent Ziv-aflibercept to treat de novo/naïve central DME has favorable outcomes and adequate safety results. Moreover, this study demonstrated the benefit of adapting the previous treatment combination for extending the interval between anti-VEGF treatments from 4 to 8 weeks, which could prevent further expenses, especially in low-income countries.However, large multicenter randomized clinical trials with longer follow-up periods are needed to assess this treatment route, especially in low-income and resourced countries.
OBJECTIVE: To assess the efficacy and safety of combining both intravitreal Ziv-aflibercept and suprachoroidal injection of triamcinolone acetonide using a custom-made needle in naïve and de novo central diabetic macular edema (DME) patients every eight weeks for 24 weeks.
METHODS: Central macular thickness was measured via spectral domain-optical coherence tomography, and best-corrected visual acuity was measured via a Snellen chart at baseline and at 4, 8, 12, 16, and 24 weeks postinjection. Additionally, cataract progression, intraocular pressure (IOP), and ocular safety were analyzed.
RESULTS: A total of 10 eyes of 6 patients were treated with suprachoroidal injections of triamcinolone acteonid combined with an intravitreal injection of Ziv-aflibercept. Vision improved from 0.69 log minimum angle of resolution (MAR) at baseline to 0.39 log MAR after treatment. Central macular thickness significantly decreased from 462.3 ± 166 μm at baseline to 362.7 ± 77.6 μm at 24 weeks postinjection.
CONCLUSIONS: Suprachoroidal injection of triamcinolone using a custom-made needle with the intravitreal agent Ziv-aflibercept to treat de novo/naïve central DME has favorable outcomes and adequate safety results. Moreover, this study demonstrated the benefit of adapting the previous treatment combination for extending the interval between anti-VEGF treatments from 4 to 8 weeks, which could prevent further expenses, especially in low-income countries.However, large multicenter randomized clinical trials with longer follow-up periods are needed to assess this treatment route, especially in low-income and resourced countries.
摘要：
背景：先前的研究表明，玻璃体内贝伐单抗和脉络膜上腔注射曲安奈德联合治疗DME具有良好的疗效。然而,需要进一步的研究。
目的：评估玻璃体内注射齐夫-阿柏西普和脉络膜上注射曲安奈德联合使用定制针头治疗初治和新发型糖尿病性黄斑水肿（DME）患者的疗效和安全性，每8周治疗24周。
方法：通过谱域光学相干断层扫描测量中央黄斑厚度，最佳矫正视力通过Snellen图在基线和注射后4,8,12,16和24周测量。此外,白内障进展，眼内压（IOP），并对眼部安全性进行了分析。
结果：6例患者的10只眼接受了脉络膜上腔注射曲安奈德联合玻璃体内注射Ziv-aflibercept治疗。视力从基线时的0.69log最小分辨率角度（MAR）提高到治疗后的0.39logMAR。中心黄斑厚度从基线的462.3±166μm显著降低至注射后24周的362.7±77.6μm。
结论：使用定制的针头和玻璃体内药物Ziv-阿柏西普的脉络膜上注射曲安奈德治疗从头/初始中央型DME具有良好的结果和足够的安全性结果。此外，这项研究表明，调整以前的治疗组合，将抗VEGF治疗的间隔时间从4周延长至8周，这可以防止进一步的开支，特别是在低收入国家。然而,需要随访时间较长的大型多中心随机临床试验来评估这种治疗途径，特别是在低收入和资源丰富的国家。
目的：评估玻璃体内注射齐夫-阿柏西普和脉络膜上注射曲安奈德联合使用定制针头治疗初治和新发型糖尿病性黄斑水肿（DME）患者的疗效和安全性，每8周治疗24周。
方法：通过谱域光学相干断层扫描测量中央黄斑厚度，最佳矫正视力通过Snellen图在基线和注射后4,8,12,16和24周测量。此外,白内障进展，眼内压（IOP），并对眼部安全性进行了分析。
结果：6例患者的10只眼接受了脉络膜上腔注射曲安奈德联合玻璃体内注射Ziv-aflibercept治疗。视力从基线时的0.69log最小分辨率角度（MAR）提高到治疗后的0.39logMAR。中心黄斑厚度从基线的462.3±166μm显著降低至注射后24周的362.7±77.6μm。
结论：使用定制的针头和玻璃体内药物Ziv-阿柏西普的脉络膜上注射曲安奈德治疗从头/初始中央型DME具有良好的结果和足够的安全性结果。此外，这项研究表明，调整以前的治疗组合，将抗VEGF治疗的间隔时间从4周延长至8周，这可以防止进一步的开支，特别是在低收入国家。然而,需要随访时间较长的大型多中心随机临床试验来评估这种治疗途径，特别是在低收入和资源丰富的国家。
