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A. Seener, F. Al-Sarireh, S. Scholtz, P. Singh, M. J. Koss, F. H. Koch; Triple Therapy in Retinal Venous Occlusion. Invest. Ophthalmol. Vis. Sci. 2008;49(13):4690.
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To report the effect of a triple therapy (TT= core pars plana vitrectomy(cppV), intravitreal triamcinolone and bevacizumab injection) for the treatment of macular edema secondary to central (CRVO) and branch retinal vein occlusion(BRVO).
Retrospective case series of 57 patients (mean age 70), divided in ischemic CRVO(n=16,group I); non-ischemic CRVO(n=12,group II) and BRVO(n=29,group III).All groups received a 23 gauge cppV (sutureless, single sclerotomy) with aspiration of 0.5ml vitreous and substitution of 0.8 mg triamcinolone and 1.25mg bevacizumab through two different openings in one probe tip. Main outcome measures included BCVA(5m Snellen), IOP, OCT and fluorescein angiography.
F/u was 12 and 24 weeks post surgery. BCVA improved from 0.02 to 0.06 (group I), 0.15 to 0.37(group II), 0.25 to 0.48 (group III). All patients, except of 4/13 (30,8% in group I) showed significant macular edema resolution. IOP rise was measured in 3/50 cases (6%). TT was continued in 10/50 cases (20%); laserphotocoagulation was conducted in 8/50 cases (16%) 6 months after TT.
TT indicates promising prelimary results concerning VA and ME resolution in non-ischemic RVO mainly, which could be enhanced by a intravasal lysis with venous catherization to increase the redistribution of intraocular oxygen already induced by the core vitrectomy.
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