Intravitreal bevacizumab versus triamcinolone acetonide for uveitic cystoid macular edema: a metaanalysis

Purpose: To carry out a meta-analysis of studies comparing intravitreal bevacizumab (IVB) with intravitreal triamcinolone acetonide (IVT) in the treatment of uveitic cystoid macular edema. Methods: Relevant publications were identified through PubMed, EMBASE, and the Cochrance Controlled Trials Register. Patients prescribed IVB verus IVT were compared in terms of central macular thickness (CMT) and best-corrected visual acuity (BCVA) at baseline and 1, 3, and 6 months after treatment. Results: Four comparative studies with 72 eyes in the IVB group and 76 eyes in the IVT group were included. Funnel plots, the Egger method, and Begg method did not show any publication bias. The IVT and IVB groups were comparable in BCVA at 1 month (weighted mean deviation [WMD] = 0.06, 95% confidence interval [CI] = -0.05-0.16, p = 0.31), 3 months (WMD = 0.09,  95% CI= -0.01-0.18, p = 0.08), and 6 months (WMD =  0.04, 95% CI = -0.02-0.11, p = 0.20), as well as change  in CMT at one month (WMD = 5.17, 95% CI = -9.2- 19.5, p = 0.48) and 3 months (WMD = 43.3, 95% CI = -11.6-98.2, p = 0.12). At 6 months, change in CMT was higher in the IVT than IVB group (WMD = 40.6, 95% CI = 8.2-73.0, p = 0.01). Conclusion: At 6 months after injection, IVT was more  effective than IVB in reducing CMT.