Kubilhan Elmas, Özgür Bilen, Ali Altýnsoy (Ankara, Turkey)

Purpose:

To evaluate the efficacy of intravitreal triamcinolone injection in eyes with macular edema due to branch retinal vein occlusion (BRVO) over a 1-year period.

Methods:

The authors performed a retrospective chart review of 18 eyes of 18 patients (mean age 71 years) who underwent intravitreal injections with 2 mg triamcinolone acetonide and 1,25 mg bevacizumab for macular edema due to BRVO. Mean follow-up was 13 months (range, 6 to 18).

Results:

Mean post injection central foveal thickness decreased to 52% of pre injection values (529 mum versus 295 mum, P = 0 .001). Final visual acuity improved in eleven eyes (range 2 to 6 Snellen lines), remained the same in six eyes (range 0 to 1 Snellen lines), and worsened in one eye (range -1 to -4 Snellen lines) compared to baseline. The retinal thickness decreased in all cases; vision improved in most cases. As the number of injections increased characteristic changes increased. Visual acuity improvement was significantly correlated with patient age (P = 0.026). Two patients developed steroid induced ocular hypertension controlled by topical medication. Cataract extraction was judged to aggravate macular edema in three of the five eyes undergoing surgery, based upon optical coherence tomography or fluorescein angiography. Median best post injection visual acuity (20/50) was significantly better than that of baseline (20/100) (P = 0.028) as well as last follow-up (20/70) (P = 0.003).

Conclusions:

Intravitreal triamcinolone and bevacizumab injection should be further evaluated as a treatment option for macular edema associated with BRVO.