Abstract
Abstract: :
Purpose: To compare the surgical outcomes of eyes that had vitrectomy with simultaneous intravitreal injection of triamcinolone acetonide (TA) to those that had vitrectomy alone for macular edema (ME) associated with branch retinal vein occlusion (BRVO). Methods: A posterior vitreous detachment (PVD) was created followed immediately by an intravitreal injection of 4 mg of TA in 26 eyes of 26 patients (TA group) with BRVO–associated ME. A simple PVD was created without TA injection in 36 eyes of 36 patients (no–TA group) with BRVO–associated ME. The best–corrected visual acuity (BCVA), fluorescein angiograms (FAs), and OCT–determined foveal retinal thickness were examined preoperatively and at 1, 3, and 6 months postoperatively. Results: The mean postoperative BCVA at 1 month was significantly improved to 0.57±0.44 log MAR units (mean ± SD) in the TA group (P=0.004), while no significant improvement was measured in the no–TA group (P=0.76). The mean BCVA was significantly better than the preoperative VA in both groups at 6 months postoperatively (P=0.001 and P=0.0004, respectively). The preoperative mean foveal thickness was 524±294 µm in the TA group and 598±177 µm in the no–TA group. The foveal thickness decreased significantly 1 month after surgery in both groups (P=0.0002 and P=0.0001, respectively), and the fovea was significantly thinner in the TA group than in the no–TA group at 1 month postoperatively (P=0.002). The foveal thickness then gradually decreased until 6 months in the no–TA group, however, the foveal thickness increased slightly at 3 months after surgery in the TA group, because 11 eyes showed a recurrence of ME and required additional TA injection. None of the no–TA eyes had a recurrence of ME. Conclusions: Simultaneous intravitreal injection of TA may have speeded up the resolution of ME, however, there were more recurrence in the TA–injected eyes. Because there was no significant difference in the improvement of macular function between two procedures at 6 months postoperatively, there may be no additional benefit in the simultaneous intravitreal injection of TA.
Keywords: vitreoretinal surgery • vascular occlusion/vascular occlusive disease