Triamcinolone Acetonide and Vitrectomy for the Treatment of Ischemic Central Retinal Vein Occlusion (CRVO)

Abstract

Abstract: : Purpose: To evaluate the efficacy of Pars Plana Vitrectomy (PPV) and Triamcinolone Acetonide (TA) for the management of ischemic central retinal vein occlusion (CRVO) Methods: Prospective, longitudinal, experimental and descriptive study in patients with ischemic CRVO with visual acuity (VA) <20/100 or those whose VA decreased more than 50% during follow–up, an area over 10 disc diameter of non–perfused retina and afferent papillary defect. Eyes with rubeosis or previous laser treatment were excluded. Al patients underwent PPV and TA with complete posterior hyaloid removal. Rubeosis, intraocular pressure (IOP), VA, and macular edema were evaluated clinically, multifocal ERG (m–ERG), fluorescein angiography (FA) and optic coherence tomography (OCT), were also performed. Follow–up was at least 6 months Results: Six eyes were evaluated. Age ranged from 57 to 81 years, (average 67.16 years). Four (60%) were male. Moderate improvement of VA was observed in 33.33% eyes and stabilized in 33.33%. IOP changed from 13.66 ± 2.3 mmHg to 16.83 ± 2.48 mmHg post–operative. No eye presented rubeosis iridis 6 months after treatment. Macular edema was evaluated with OCT: Pre–operative average was 974.33 ± 392 µm; first month post–operative was 960 ± 79.89 µm and third month 128.33 ± 94.3 µm. Macular edema, m–ERG, FA and OCT showed improvement until the last day of follow–up Conclusions: Intravitreal TA and PPV for treatment of ischemic CRVO appears to be an effective measure to achieve improvement and/or stabilization of VA with minimal complications

Keywords: vascular occlusion/vascular occlusive disease • vitreoretinal surgery • corticosteroids