Intravitreal Triamcinolone Injection for Macular Edema Secondary to Retinal Vein Occlusion

Abstract

Abstract: : Purpose: To determine the efficacy of intravitreal triamcinolone acetonide (IVT) injection in patients with macular edema secondary to retinal vein occlusions. Methods: A retrospective review of 158 patients (161 eyes) receiving 1 mg to 4 mg of IVT was conducted. The main outcome measures included Snellen visual acuity, the clinical appearance of macular edema, and perifoveal leakage on fluorescein angiography. Patients were followed at 1–month, 3–month, 6–month, and 12–month intervals. Results: Of the 161 eyes with macular edema analyzed in this study, 83 eyes were secondary to branch retinal vein occlusion, 61 eyes were secondary to central retinal vein occlusion, and 17 eyes were secondary to hemicentral retinal vein occlusion. Forty–eight eyes received laser treatment and 45 patients underwent cataract extraction prior to IVT injection. At 3 months following initial IVT injection, 48.8% of eyes gained 2 or more lines of Snellen visual acuity, 34.4% were the same, and 16.8 % worsened by 2 or more lines of Snellen visual acuity. At 6 months following initial IVT injection, 44.7% of eyes gained 2 or more lines of Snellen visual acuity, 43.9% were the same, and 11.4 % worsened by 2 or more lines of Snellen visual acuity. At 3 months, macular edema resolved in 15% of eyes, improved in 26% of eyes, was unchanged in 31% of eyes, and worsened in 28% of eyes. At 6 months, macular edema resolved in 20% of eyes, improved in 21% of eyes, was unchanged in 32% of eyes, and worsened in 27% of eyes. Forty–four eyes required laser treatment and 65 eyes needed at least one additional IVT injection during follow–up. Mean follow–up was 10 months. Conclusions: Intravitreal triamcinolone acetonide injection appears to be a useful treatment modality for macular edema associated with retinal vein occlusion. Multiple injections may be necessary in order to induce resolution of macular edema. A randomized clinical trial, currently enrolling patients, will yield useful further data as to the indication of IVT in the treatment of retinal vein occlusions.

Keywords: injection • blood supply