Short-term efficacy of intravitreal triamcinolone acetonide for macular edema secondary to retinal vein occlusion that is refractory to intravitreal bevacizumab

• Main Authors: Seul Gi Yoo, Jae Hui Kim, Tae Gon Lee, Chul Gu Kim, Jong Woo Kim
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2015-01-01
• Series: Indian Journal of Ophthalmology
• Subjects: Cup to disc ratio; disc area; glaucoma probability score; moorfields regression analysis; optical coherence tomography; Antioxidant supplementation; diabetes mellitus; free oxygen radicals test; nonproliferative diabetic retinopathy; reactive oxygen species; In vivo confocal microscopy; keratocyte density; prostaglandin analogues; Chronic glaucoma patients; economic burden; socioeconomic profile; Bevacizumab; macular edema; refractory; retinal vein occlusion; triamcinolone acetonide
• Online Access: http://www.ijo.in/article.asp?issn=0301-4738;year=2015;volume=63;issue=1;spage=25;epage=29;aulast=Yoo

Aims: To evaluate the 1-month efficacy of intravitreal triamcinolone acetonide (TA) in treating macular edema secondary to retinal vein occlusion (RVO) that was refractory to intravitreal bevacizumab. Materials and Methods: This retrospective, observational study included 23 eyes from 23 patients with macular edema secondary to RVO. Macular edema that did not respond to two or more consecutive intravitreal bevacizumab injections was treated with intravitreal TA. Central foveal thickness (CFT) and best-corrected visual acuity (BCVA) were compared before and one month after TA injection. Results: Fifteen eyes were diagnosed with central RVO, and eight eyes were diagnosed with branch RVO. All patients were previously treated with 2.4 ± 0.6 intravitreal bevacizumab injections. The TA injection was performed, on average, 5.8 ± 1.4 weeks after the last bevacizumab injection. The CFT before TA injection was 516.6 ± 112.4 μm and significantly decreased to 402.3 ± 159.7 μm after TA therapy (P < 0.001). The logarithm of the minimal angle of resolution BCVA was 0.72 ± 0.34 before TA therapy and was not significantly improved by the treatment (0.67 ± 0.35, P = 0.119), despite a decrease in CFT. However, seven eyes (30.4%) had a BCVA gain of one or more lines. Conclusions: Intravitreal TA therapy was beneficial in some patients with macular edema secondary to RVO that was refractory to intravitreal bevacizumab therapy. This study suggests that intravitreal TA should be considered as a treatment option for refractory macular edema.