Intervention protocol
STERILE, ANTERIOR, SCLERA
Every participant received three consecutive anesthetic drops every five minutes before beginning the procedure. During the first injection session, after placing an eyelid speculum and disinfecting the ocular surface with a 10% povidone-iodine solution for 30 seconds in all study eyes, 0.1 ml (4 mg) of TA (Exir Pharmaceutical Co., Iran) was injected into SCS 3–4 mm posterior to the limbus supratemporally with a 900–1000 μm terminally sharp sterile 30-gauge custom made needle in the combination arm. Detailed steps of preparing the needles was shown in Fig. Detailed steps of preparing the custom made needle to perform suprachoroidal triamcinolone acetonide injection. A different syringe was then used to inject 1.25 mg per 0.05 ml of IVB (Avastin, Roche) into the superior/temporal quadrant 3–4 mm posterior to the limbus. Anterior chamber paracentesis was ultimately performed to reduce IOP. A sham injection performed by pressing the sclera with a needleless syringe was followed by injecting (1.25 mg/0.05 ml) of IVB into the supratemporal quadrant 3–4 mm posterior to the limbus in the monotherapy arm. The patients were monitored in the clinic for about 30 minutes after the injections. Two days later, the injection was performed into the other eye of the patients whose both eyes were included in the study. All the participants received the same dose of IVB per month as that of the first session the following 2 months.The patients were examined at baseline, and the first injection was performed within 7 days. Follow-ups were performed on the 28-35th day, and 90-100th day of the first injection session. Visual acuity was evaluated with and without refraction using a standard Snellen chart with the distance of 20 ft (6 m). Detailed ophthalmologic examinations of the individual study eyes included slit-lamp biomicroscopy, dilated fundus examination, IOP measurement and SD-OCT, which was used to evaluate CST and macular volume (MV) were then performed. Experts blinded to the grouping and data collected from the previous examinations each performed a single study task.