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T. Kawaji, Y. Inomata, A. Takano, N. Sagara, M. Fukukshima, H. Tanihara; Trans–Tenon’s Retrobulbar Triamcinolone Injection for Macular Edema Associated With Branch Retinal Vein Occlusion . Invest. Ophthalmol. Vis. Sci. 2006;47(13):4271.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the safety and effectiveness of trans–Tenon’s retrobulbar triamcinolone injection for macular edema associated with branch retinal vein occlusion (BRVO).
This is a prospective interventional case series. Forty eyes of 40 patients with BRVO, were divided into two groups: eyes with posterior vitreous detachment (PVD) (n=21) or without PVD (n=19), were enrolled in this study. The criteria of this study is as follows: 1) Macular edema associated with BRVO more than 3 months or progressive decrease in visual acuity even within 3 months, 2) Best–corrected visual acuity of 0.5 or worse, 3) Retinal thickness at the foveal center of greater than 250 µm by optical coherence tomography (OCT). Trans–Tenon’s retrobulbar triamcinolone injection of 20mg triamcinolone was performed and the visual and anatomic responses were evaluated. The mean follow–up period after triamcinolone injecton was 7.2 months (range, 3–16 months).
The mean duration between onset and triamcinolone injection was 5.7 months (2–15) in eyes with PVD and 4.7 months (2–18) in eyes without PVD. The foveal thickness by OCT was reduced significantly at last follow–up after triamcinolone injecton in both groups. Especially, rate of reduced foveal thickness in eyes with PVD was significantly high compared to that in eyes without PVD (P<.05, paired t–test). Five eyes with PVD received two injections and three eyes received three injections. Four eyes without PVD received two injections and four eyes received vitrectomy, Visual acuity improved significantly in both groups at last follow–up. Improvement of visual acuity by at least 0.20 logMAR was seen in 62% of eyes with PVD and 68% of eyes without PVD. Intraocular pressure (IOP) elevation of 22 mmHg or higher was found in 25%, and IOP was controlled with anti–glaucoma medications in all cases.
Our studies showed that trans–Tenon’s retrobulbar triamcinolone injection is safe and effective for macular edema associated with BRVO, especially for eyes with PVD. Further studies are needed to define the most efficient surgical management of BRVO.
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