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


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


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.