Yun-Sik Yang, Cang-uk Choi, Yong-Woo Kim

Purpose:

To evaluate the difference of intravitreal triamcinolone acetonide in the management of macular edema secondary to perfusion type and ischemic type branch retinal vein occlusion (BRVO).

Methods:

44 patients consecutive patients were selected with a BRVO with macular edema. 23 were perfusion type and twenty one were ischemic type BRVO. These patients received a single intravitreal injection of 4 mg of triamcinolone acetonide (40 mg/mL). The followup period was over 6 months. The macular edema was assessed by the amount of retinal thickening on clinical examination using the Mainster contact lens and by the area and intensity of staining on fluorescein angiography. Changes in corrected visual acuity and amount of macular edema were assessed in the both ischemic and perfusion type.

Results:

The mean pre-treatment and post-treatment LogMAR visual acuity in the perfusion type was 1.01 and 0.69 (p value =0.01) vs in the ischemic type 0.99 and 0.81 (p value =0.09), though macular edema were relieved on both type BRVO. There was no significance between visual acuity change and pre-treatment visual acuity nor between upper temporal and lower temporal BRVO.

Conclusion:

This study shows that there is a treatment benefit of intravitreal triamcinolone in terms of visual acuity for perfusion type BRVO but not ischemic type BRVO.

Take-home message:

There is a treatment benefit of IVTA in perfusion type BRVO.