Treatment of branch retinal vein occlusion induced macular edema in treatment-naïve cases with a single intravitreal triamcinolone or bevacizumab injection.

Abstract

BACKGROUND: To evaluate the effects of a single intravitreal injection of triamcinolone acetonide (ivTA) or bevacizumab (ivBe) on visual acuity and central macular thickness (CMT) in cases of macular edema secondary to branch retinal vein occlusion (BRVO) for eyes that are treatment-naïve. METHODS: This consecutive, retrospective, nonrandomized, clinical interventional study included 83 patients (83 eyes) with macular edema secondary to BRVO who received single ivTA (25 patients) or ivBe (24 patients) injections, or no treatment (controls, 34). The main outcomes included CMT measurements using optical coherence tomography (OCT) and best-corrected visual acuity (BCVA). RESULTS: CMT decreased significantly from baseline at 4, 8, 12 and 24 weeks after treatment (p < 0.05) in both the intravitreal groups and the control group. BCVA improved significantly from baseline at 4 and 8 weeks after treatment among the ivTA group (p < 0.05) and at 4, 8 and 12 weeks after treatment among the ivBe group (p < 0.05). Comparing CMT between the groups, significant differences were found between ivTA and control groups and ivBe and control groups at the 4- and 8- week checkpoints (p < 0.05). Significant differences were found in BCVA only between ivBe and control groups at the 8-week checkpoint (p = 0.049). No significant differences were found for CMT and BCVA between the ivBe and ivTA groups (p > 0.05) at any checkpoint after treatment. No patient experienced immediate procedure-related complications or any obvious systemic adverse events in either the ivTA group or the ivBe group. Delayed complications included steroid induced ocular hypertension in eight eyes (32%) and development of posterior subcapsular cataracts in five eyes (28%) in the ivTA group. CONCLUSIONS: Both the ivTA and ivBe therapies were beneficial short-term treatment options for the treatment of macular edema secondary to BRVO. However, the ivBe treatment appears to be safer and less prone to adverse side effects such as ocular hypertension and cataract compared with ivTA therapy.