Intravitreal Triamcinolone for the Treatment of Ischemic Macular Edema Associated With Branch Retinal Vein Occlusion

• Published in: American journal of ophthalmology Vol. 141; no. 5; pp. 876 - 883.e1
• Main Authors: Chen, Simon D.M., Sundaram, Venki, Lochhead, Jonathan, Patel, C.K.
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01-05-2006; Elsevier; Elsevier Limited
• Subjects: Adult; Aged; Aged, 80 and over; Biological and medical sciences; Company reports; Female; Fluorescein Angiography; Glucocorticoids - adverse effects; Glucocorticoids - therapeutic use; Humans; Hypertension; Injections; Intraocular Pressure - drug effects; Ischemia; Ischemia - drug therapy; Ischemia - etiology; Macular degeneration; Macular Edema - drug therapy; Macular Edema - etiology; Male; Medical sciences; Middle Aged; Miscellaneous; Ophthalmology; Pharmaceutical industry; Prospective Studies; Retinal Vein Occlusion - complications; Retinal Vessels - drug effects; Retinal Vessels - pathology; Retinopathies; Software; Statistical analysis; Tomography, Optical Coherence; Treatment Outcome; Triamcinolone Acetonide - adverse effects; Triamcinolone Acetonide - therapeutic use; Visual Acuity; Vitreous Body; Corticosteroid; Retinopathy; Antiinflammatory agent; Cardiovascular disease; Vitreous body; Retinal edema; Venous disease; Vascular disease; Macula; Central retinal vein occlusion; Eye disease; Association; Treatment; Ischemia; Branch; Adrenal hormone; Ophthalmology; Triamcinolone
• ISSN: 0002-9394; 1879-1891
• DOI: 10.1016/j.ajo.2005.12.011

To evaluate the safety and efficacy of intravitreal triamcinolone acetonide (IVTA) for ischemic macular edema associated with branch retinal vein occlusion (BRVO) and foveal ischemia.
Prospective interventional case series.
setting:
Clinical practice.
study population:
Eighteen eyes of 18 patients with macular edema associated with BRVO and foveal ischemia.
intervention:
Four mg IVTA.
main outcome measures:
Visual acuity (VA), optical coherence tomography, macular thickness measurements, and treatment-related complications.
The mean duration of BRVO before treatment was 14 months. All patients were followed for a minimum of nine months, and 12 patients completed 12 months follow-up. The mean logarithm of the minimum angle of resolution (logMAR) VA improved significantly from 0.81 ± 0.36 at baseline to 0.65 ± 0.30 at one month (
P = .03) but did not vary significantly from baseline at three, six, nine, and 12 months. Macular thickness improved significantly in all eyes from a mean of 400 ± 134 μm preinjection, to 228 ± 58 μm at one month (
P < .01) and 256 ± 121 μm at three months (
P < .01) but did not vary significantly from baseline at six, nine, and 12 months. Eight eyes developed posterior subcapsular cataract, intraocular pressure (IOP) exceeded 21 mm Hg in four eyes, and two eyes developed vitreomacular traction during follow-up.
IVTA is effective in reducing ischemic macular edema associated with BRVO and foveal capillary nonperfusion. This reduction is often associated with a temporary improvement in VA. Raised IOP and development of posterior subcapsular cataract are disadvantages of this treatment.