A Prospective Evaluation of Intravitreal Injection of Triamcinolone Acetonide (KenalogÒ) for Macular Edema Secondary to Central Retinal Vein Occlusion

Abstract

Abstract: : Purpose: We evaluated the efficacy of Triamcinolone acetonide (TA) in patients with macular edema and central retinal vein occlusion (CRVO). Methods: Prospective, longitudinal, descriptive and experimental study. Ten consecutive patients with CRVO and macular edema were treated with a single intravitreal injection of TA. Follow-up was up to 6 months. All patients had visual acuity of 20/200 or less. A single dose (4mg/0.1ml) was injected 3.5 mm posterior to the limbus using a 30 gauge needle. We evaluated best corrected visual acuity (BCVA), intraocular pressure (IOP), color fundus photography, fluorescein angiography, multifocal electroretinography (mERG), optic coherence tomography (OCT) and complications at 1, 3 and 6 months after the procedure. Results: Ten phakic eyes of ten patients were included (mean age 63.4). Two patients improved from 20/500 to 20/300, and eight had no improvement of the visual acuity. The preoperative IOP was between 8 to 12 mmHg (mean 11) and postoperative IOP ranged from 13 to 21mmHg (mean 16.33). Two patients had elevated IOP (22-30mmHg), controlled by topical antihypertensives. Color fundus photography, fluorescein angiography and mERG showed no improvement after the injection. We observed a significant decrease in macular edema (P < 0.028 Wilcoxon). Preoperative macular thickness measured by OCT, ranged between 611 to 900 µ (mean 786) and between 283 to 700 µ (mean 559.75) one month after the procedure. We found no correlation between macular thickness decrease and visual acuity improvement Conclusions: Our results suggest that eyes with macular edema due to CRVO that undergo intravitreal injection of TA show a decrease in macular thickness but no improvement in macular function or visual acuity

Keywords: corticosteroids • vascular occlusion/vascular occlusive disease