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KMID : 0360220180590080730
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Journal of the Korean Ophthalmological Society
2018 Volume.59 No. 8 p.730 ~ p.737
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Effectiveness of Intravitreal Preservative-free Triamcinolone Injection for Refractory Macular Edema Secondary to Retinal Vein Occlusion
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Lee Chang-Hwan
Chang Moo-Hwan
Seo Young-Seung
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Abstract
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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.
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KEYWORD
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Intraocular pressure, Intravitreal injection, Macular edema, Preservative-free triamcinolone, Retinal vein occlusion
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