Abstract
Abstract: :
Purpose:To evaluate the influence of intravitreal injection of 4 mg triamcinolone acetonide on visual acuity and macular thickness in patients with macular edema due to branch retinal vein occlusion (BRVO) or central retinal vein occlusion (CRVO). Methods: Two groups of patients were included in this prospective study: Group 1: Patients with macular edema due to CRVO, and group 2: patients with non–ischemic BRVO with persistent macular edema after grid laser photocoagulation or with ischemic BRVO. Examination included assessment of best corrected visual acuity (BCVA) using logMAR charts for distance vision and logRAD charts for near vision, slit lamp examination and ophthalmoscopy, IOP measurement, and high resolution imaging by optical coherence tomography (OCT), and was done preoperative and postoperative at 1 week, 1 month, 3 months, 6 months (BRVO), and additionally 9 months in CRVO. Results: 12 patients (mean age 65.1±12.1) were included in group 1, and 10 patients (mean age 67.9±10.2) were included in group 2. In group 1, preoperatively, 1 week, 1 month, 3, 6, and 9 months postoperatively the mean BCVA for distance was 0.9±0.5, 0.6±0.3 (p=0.01), 0.5±0.3 (p=0.04), 0.46±0.3 (p=0.002), 0.6±0.2 (p=0.03), and 0.76±0.4 (p=0.18), respectively. Mean BCVA for near was 0.9±0.2, 0.78±0.2 (p=0.02), 0.57±0.3 (p=0.008), 0.6±0.3 (p=0.001), 0.6±0.3 (p=0.03), and 0.76±0.4 (p=0.18), respectively. Mean macular thickness was 468±135 (µm), 331±72 (p=0.001), 310±55 (p=0.01), 314±130 (p=0.98), and 404±165 (p=0.053), respectively. In group 2, preoperatively, 1 week, 1 month, 3, and 6 months postoperatively mean BCVA for distance was 1.2±0.7, 0.6±0.2 (p=0.04), 0.7±0.4 (p=0.1), 0.7±0.3 (p=0.14), and 0.9±0.5 (p=0.3), respectively. Mean BCVA for near was 1.1±0.3, 0.8±0.3 (p=0.02 ), 0.7±0.4 (p=0.02), 0.8±0.3 (p=0.06), and 1.0±0.2 (p=0.15), respectively. Mean macular thickness was 475±183 (µm), 302±109 (p=0.03), 327±148 (p=0.07), 387±180 (p=0.16), and 465±181 (p=0.5), respectively. 6 patients needed topical antiglaucomatous medication. Conclusion: Intravitreal injection of 4 mg triamcinolone led to a significant improve in visual acuity in patients with macular edema due to CRVO and BRVO. Although the significant effect did persist only for 6 months in CRVO, and for 3 months in BRVO, randomized studies are needed to further examine this therapeutic approach. None