J Korean Ophthalmol Soc.  2018 Aug;59(8):730-737. 10.3341/jkos.2018.59.8.730.

Effectiveness of Intravitreal Preservative-free Triamcinolone Injection for Refractory Macular Edema Secondary to Retinal Vein Occlusion

Affiliations
  • 1Department of Ophthalmology, Dankook University Hospital, Dankook University College of Medicine, Cheonan, Korea. mailcarr@naver.com

Abstract

PURPOSE
To evaluate the efficacy of intravitreal preservative-free triamcinolone acetonide (Maqaid®) injection for the treatment of macular edema secondary to retinal vein occlusion (RVO) refractory to intravitreal bevacizumab injections.
METHODS
This retrospective, observational study included 17 eyes of 17 patients with refractory macular edema secondary to RVO. The patients with macular edema unresponsive to intravitreal bevacizumab injections were treated with intravitreal preservative-free triamcinolone acetonide (Maqaid®) injection. Best-corrected visual acuity (BCVA) and central foveal thickness (CFT) based on optical coherence tomography were evaluated before intravitreal triamcinolone injection (IVTA), 1 month and 3 months after IVTA injection. intraocular pressure (IOP) changes were analyzed up to 6 months.
RESULTS
The logarithm of the minimal angle of resolution (logMAR) BCVA was decreased from 0.56 ± 0.32 to 0.41 ± 0.32 after 1 month with statistical significance (p = 0.006) and to 0.47 ± 0.36 after 3 months of IVTA without statistical significance (p = 0.204). CFT was significantly improved from 474.82 ± 91.91 µm to 262.58 ± 60.11 µm after 1 month and to 339.58 ± 152.48 µm after 3 months of IVTA injection (p ≤ 0.001 and 0.005, respectively). IOP was significantly increased from 13.11 ± 2.66 mmHg to 16.64 ± 5.66 mmHg after 1 month and to 17.05 ± 7.21 µm after 3 months of IVTA injection (p = 0.024 and 0.026, respectively). Treatment-associated IOP elevation was manageable with antiglaucoma medications. IOP was 15.13 ± 3.90 mmHg after 6 months of IVTA injection (p = 0.023).
CONCLUSIONS
Intravitreal preservative-free triamcinolone (Maqaid®) Injection improves BCVA and reduces CFT in some patients with macular edema secondary to RVO refractory to intravitreal bevacizumab therapy. There were no serious vision-threatening complications associated with intravitreal preservative-free triamcinolone (Maqaid®) therapy during the study period. Intravitreal preservative-free triamcinolone (Maqaid®) could be considered as a treatment option for refractory macular edema associated with RVO.

Keyword

Intraocular pressure; Intravitreal injection; Macular edema; Preservative-free triamcinolone; Retinal vein occlusion

MeSH Terms

Bevacizumab
Humans
Intraocular Pressure
Intravitreal Injections
Macular Edema*
Observational Study
Retinal Vein Occlusion*
Retinal Vein*
Retinaldehyde*
Retrospective Studies
Tomography, Optical Coherence
Triamcinolone Acetonide
Triamcinolone*
Visual Acuity
Bevacizumab
Retinaldehyde
Triamcinolone
Triamcinolone Acetonide
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