Korean J Ophthalmol.  2014 Feb;28(1):19-25. 10.3341/kjo.2014.28.1.19.

Comparison of Injection of Intravitreal Drugs with Standard Care in Macular Edema Secondary to Branch Retinal Vein Occlusion

• Lee K
• Jung H
• Sohn J

• KMID: 1792090
• DOI: http://doi.org/10.3341/kjo.2014.28.1.19

Abstract

PURPOSE
To compare the long-term efficacy and safety of intravitreal triamcinolon with or without rescue laser therapy (intravitreal triamcinolone injection [IVTA] group), bevacizumab with or without rescue laser treatment (intravitreal bevacizumab injection [IVB] group), or a combination of both with or without rescue laser therapy (IVTA + IVB group), with standard care for patients with macular edema secondary to branch retinal vein occlusion (BRVO).
METHODS
We reviewed the medical records of 151 patients treated with intravitreal injection with or without rescue laser for treatment of macular edema caused by BRVO, and who were followed up at 1, 3, 6, 12, and 24 months. During the observation period, rescue grid laser or repeated intravitreal injection with initial drug was performed if recurrence of macular edema was confirmed. Visual acuity, change in visual acuity, and intraocular pressure were compared in each phase.
RESULTS
Totals of 16%, 5.6%, and 0% of participants in the three groups showed significant visual loss of more than three lines of the Snellen chart at last follow-up. The IVTA group was the least effective treatment modality, with statistical significance. The development rates of elevated intraocular pressure were similar among the groups.
CONCLUSIONS
Although IVTA yielded effects similar to those of standard grid photocoagulation based on the Standard Care vs Corticosteroid for Retinal Vein Occlusion study, IVB or IVTA + IVB with or without rescue laser treatment resulted in improvement in visual acuity at 24 months after the start of treatment and was associated with few serious adverse side effects. Thus, these approaches could be useful for treating macular edema arising secondary to BRVO.

Keyword

Intravitreal injection; Macular edema; Retinal vein occlusion

MeSH Terms

Angiogenesis Inhibitors/administration & dosage
Antibodies, Monoclonal, Humanized/*administration & dosage
Female
Follow-Up Studies
Glucocorticoids/administration & dosage
Humans
Intravitreal Injections
Laser Therapy/*methods
Macular Edema/diagnosis/etiology/*therapy
Male
Middle Aged
Recurrence
Retinal Vein Occlusion/*complications/diagnosis/therapy
Retrospective Studies
Tomography, Optical Coherence
Treatment Outcome
Triamcinolone Acetonide/*administration & dosage
Vascular Endothelial Growth Factor A/*antagonists & inhibitors
Visual Acuity
Angiogenesis Inhibitors
Antibodies, Monoclonal, Humanized
Glucocorticoids
Triamcinolone Acetonide
Vascular Endothelial Growth Factor A