Abstract
Purpose: :
To evaluate the long term efficacy of intravitreal triamcinolone (IV–TA) injections for the treatment of patients diagnosed with nonischemic central retinal vein occlusion (NCRVO) and macular edema.
Methods: :
A retrospective study was performed to evaluate the visual acuities, intraocular pressures, and lens appearance of patients with NCRVO at the time of their diagnosis during routine follow–up over a 12–month interval. Patients were divided into two categories: those who received intravitreal triamcinolone injections, and those who did not.
Results: :
Twelve eyes of 12 patients were included in this study. The control group consisted of 5 patients. After one year of follow–up, 3 patients in the untreated group had no change in vision; 2 patients had worsening of vision by 2 or more lines on Snellen acuity testing. 1 patient converted to ischemic CRVO. None of the patients in the control group developed increased intraocular pressure or showed a progression of cataract formation. 3 of the untreated patients showed improvement in macular edema over time. 7 patients were included in the treatment group. All of the patients demonstrated improvement in the amount of macular edema on exam following treatment with IV–TA. Visual acuity post–treatment improved in 5 patients by two or more lines on Snellen acuity testing. 2 patients did not demonstrate change between pre– and post–treatment visual acuities. Cataract formation was not observed in 3 patients post–treatment; 2 demonstrated significant cataract progression following IV–TA injection and 1 patient underwent KPE–IOL during follow–up; 2 patients were pseudophakic in the involved eye at the time of diagnosis and treatment. 4 patients developed increased intraocular pressure (IOP) post–treatment, which necessitated topical IOP–lowering therapy. 3 patients demonstrated no change in IOP. 3 patients underwent additional treatment for the macular edema, such as grid laser photocoagulation and/or sub–tenons triamcinolone injections.
Conclusions: :
Our data suggests that IV–TA may be efficacious in the treatment of macular edema associated with nonischemic central retinal vein occlusion in the long term. Treatment with IV–TA appears to result in improvement or stabilization of visual acuity post–injection, along with resolution of macular edema in patients several months after injection. Glaucoma and cataract formation appear to be associated complications.
Keywords: ischemia • macula/fovea • vascular occlusion/vascular occlusive disease