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Study: Triamcinolone improves BRVO macular edema regardless of prior grid laser treatment
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Injecting triamcinolone acetonide intravitreally can significantly reduce macular edema associated with branch retinal vein occlusion, regardless of whether eyes had previously received grid laser treatment, according to a study by researchers in Turkey. However, eyes that received intravitreal triamcinolone as a primary treatment showed a significantly better improvement in vision, the study authors noted.
"Larger studies are necessary to find the best approach (either grid laser or intravitreal triamcinolone acetonide) to [treating] patients with macular edema associated with BRVO (branch retinal vein occlusion)," the authors said.
Mehmet Cakir, MD, and colleagues at Beyoglu Eye Research and Education Hospital in Istanbul evaluated the efficacy of intravitreal triamcinolone acetonide in 37 eyes with macular edema secondary to BRVO. All eyes had a best corrected visual acuity worse than 20/40.
Surgeons used intravitreal triamcinolone as the primary treatment in 25 eyes and as a secondary treatment in 12 eyes. These 12 eyes had failed to gain at least two lines of vision after previous treatment with grid laser photocoagulation, according to the study.
Patients who received triamcinolone as their primary treatment showed a significant improvement in BCVA throughout follow-up (P < .05). However, only a small gain in BCVA was observed at 3 months among patients in the secondary treatment group (P = .04).
At 9.6 months mean follow-up, BCVA averaged 0.06 in the primary treatment group and 0.17 in the secondary treatment group, according to the study.
At baseline, central macular thickness averaged 434.8 µm in the primary treatment group and 389 µm in the secondary treatment group.
Among patients in the primary treatment group, central macular thickness decreased at 1 month after injection and remained significantly decreased at 6 months follow-up (P < .05). However, a slight reduction in central macular thickness was observed only at 1 month follow-up in the secondary treatment group (P = .02), the authors reported.
"[Pre-intravitreal triamcinolone] BCVA was found to be the single statistically significant predictor of BCVA gain following [intravitreal triamcinolone] injection," they noted.
The study is published in the March issue of Retina.