Short-Term Outcomes of Intravitreal Brolucizumab Injection and Sub-Tenon Injection of Triamcinolone Acetonide for Diabetic Macular Edema: A Pilot Study

Abstract

Purpose: To evaluate the short-term efficacy and safety of intravitreal brolucizumab combined with sub-Tenon triamcinolone acetonide in treating diabetic macular edema (DME). Methods: Medical records were retrospectively reviewed for 11 patients with DME (14 eyes) treated with intravitreal brolucizumab and sub-Tenon triamcinolone acetonide injections at our hospital using a 1 + pro re nata injection regimen. Data collected included best-corrected visual acuity (BCVA), central macular thickness (CMT), injection frequency, and adverse events. Patients were followed up for at least 6 months. Results: At baseline, the mean BCVA was 0.43 logMAR, and the mean CMT was 418.4 µm. After 1 month of treatment, BCVA improved, and CMT significantly decreased in all cases. These improvements were maintained over 6 months of treatment, with a mean injection frequency of 1.14 injections over 6 months. This combination therapy was effective both in patients who were treatment naïve at baseline and in those who were previously treated with an antivascular endothelial growth factor agent. No significant complications, such as intraocular inflammation or elevated intraocular pressure, were observed during follow-up. Conclusions: Combination therapy with intravitreal brolucizumab and sub-Tenon triamcinolone acetonide may offer anatomic benefits in patients with DME, requiring fewer injections. Further evaluation using larger, prospectively designed studies is warranted to confirm its functional efficacy and long-term safety.