Alireza Ramezani, Morteza Entezari, Siamak Moradian, Hamed Esfandiari, Babak Dehsarvi, Masoud Soheilian, Hamid Ahmadieh, Mehdi Yaseri (Tehran, Iran)

Advantages:

Repeated intravitreal injections of bevacizumab (IVB) are more effective than repeated intravitreal injections of triamcinolone (IVT) in acute retinal vein occlusion (RVO).

Methods:

In a randomized clinical trial, 18 eyes with recent onset (less than 2 months) central RVO and 32 eyes with recent onset branch RVO were randomly and separately assigned to two groups. IVB group (18 eyes) received 3 monthly injections of IVB (1.25 mg) and IVT group (14 eyes) received 2 injections of 2 mg IVT two months apart.

Effectiveness / Safety:

Mean BCVA improved up to 6 months in the IVB group; -0.28±0.20, -.28±0.21, and -0.27±0.48 logMAR, respectively at 3, 4 and 6 months. It remained relatively stable in the IVT group; -0.10±0.22, -0.12±0.49, and -0.03±0.25 logMAR. However, intergroup differences reach to a significant level only at month 3 (P=0.004). Correspondingly, CMT reduction was greater in the IVB group, although not to a significant level. It was -81±132 & -124±145 microns in the IVB and -55±291 & -52±242 microns in the IVT groups, respectively at months 3 and 6. Therefore, we may conclude that the therapeutic effect of 3 monthly IVB injections on acute RVO is greater than that of the 2 IVT injections (2 months apart) in terms of VA improvement.

Take home message:

Recent onset branch and central retinal vein occlusion are better to be treated with repeated intravitreal bevacizumab injections than with repeated intravitreal triamcinolone injections.