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V. H. Tran, A. Ambresin, T. J. Wolfensberger; Posterior Sub-Tenon Triamcinolone Injection for Macular Edema Associated With Retinal Vein Occlusion. Invest. Ophthalmol. Vis. Sci. 2007;48(13):1548.
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To evaluate the effectiveness and safety of posterior sub-Tenon retrobulbar triamcinolone injection for macular edema associated with central (CRVO) or branch retinal vein occlusion (BRVO).
In a prospective interventional case series manner, the study included 17 eyes of 17 patients characterized by macular edema lasting more than 3 months. Nine eyes presented with CRVO, 8 eyes with BRVO. One patient with CRVO and 1 with BRVO had undergone previous vitrectomy associated with intravitreal triamcinolone. Posterior sub-Tenon injection of 40 mg triamcinolone was performed in topical anesthesia, and visual and anatomic responses were evaluated.
Mean foveal thickness was 535.9 ± 113.8 µm preoperatively, 344.2 ± 155.9 µm at 1 month follow-up, 306.3 ± 142.7 µm at 3 month follow-up and 278.3 ± 133.0 µm at 6 month follow-up. Statistical analysis showed significant differences between preoperative and postoperative measurements (P < .0001, at 1 and 6 months, paired t test). Improvement of visual acuity by at least 0.2 logMAR (logarithm of the minimum angle of resolution) was seen in 12 (70%) of the 17 eyes. Patients who had undergone vitrectomy previously had a better response on foveal thickness; however the visual acuity did not improved more than the overall treated patients. Intraocular pressure elevation of 22 mmHg or higher was found in 5 (29%) of 17 eyes and controlled with antiglaucoma medication in all cases. Cataract progression was noted in 4 of 14 phakic eyes.
Posterior sub-Tenon injection of triamcinolone appears to be an effective treatment for long-standing macular edema associated with CRVO or BRVO.
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