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R. Mintz, M.W. Johnson, D.N. Zacks; Intravitreal Triamcinolone (Kenalog) Injection for Macular Edema Associated with Retinal Venous Occlusive Disease . Invest. Ophthalmol. Vis. Sci. 2004;45(13):4573.
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Purpose:To evaluate efficacy of intravitreal triamcinolone acetonide (Kenalog) (IVK) injection for treatment of macular edema associated with retinal venous occlusive disease. Methods:A retrospective review of patients with retinal venous occlusive disease and associated macular edema who were treated with intravitreal Kenalog injections since Jan 1, 2003 was performed. A standardized method of IVK injection was used. Type of venous occlusion was determined by clinical examination and fluorescein angiography (FA) obtained on initial presentation. Data recorded includes age, gender, involved eye, pre– and post–treatment visual acuity, and response of edema to treatment as determined by biomicroscopy, fluorescein angiography, and optical computed tomography (OCT). Adverse effects of IVK injection were also reviewed. Results:Fifteen eyes of 15 patients met the inclusion criteria. Age range was 34–78, with a mean age of 64.5 years. The morbidity was branch vein occlusion in 4 patients, hemi–retinal vein occlusion in 2, nonischemic central retinal vein occlusion in 8, and ischemic central retinal vein occlusion in 1. Time from diagnosis to treatment ranged from 1 month to 2 years. Follow–up after IVK injection ranged from 1 week to 8 months. Thirteen (87%) of 15 eyes had clinically evident improvement in macular edema. Ten (66%) of 15 eyes showed improvement in visual acuity of 3 or more lines. Of the remaining eyes, four were stable and one had worsening visual acuity. Most (80%) of the eyes that experienced visual improvement did so by their 1 week post–operative visit. Three eyes required re–injection during the follow–up period, though only one responded with visual improvement after the re–injection. Complications of IVK injection included increased intra–ocular pressure (IOP) requiring further treatment in 7 (47%) eyes. Conclusions:Our data suggests that IVK injection may play an important role in the treatment of macular edema associated with retinal venous occlusive disease. Further clinical research is needed to determine what factors may be predictive of visual improvement following this procedure.
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