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KMID : 0360220180590090834
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Journal of the Korean Ophthalmological Society
2018 Volume.59 No. 9 p.834 ~ p.841
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A Comparison of Three Intravitreal Modalities of Branch Retinal Vein Occlusion Macular Edema
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Song Han
Song Hee-Jun
Yang Ji-Ho
Kim Do-Gyun
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Abstract
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Purpose: Short-term results regarding the efficacy of intravitreal bevacizumab, dexamethasone implants, and triamcinolone-bevacizumab in macular edema (ME) secondary to branch retinal vein occlusion (BRVO) were compared.
Methods: This study included 30 eyes of with BRVO and ME. Patients received the following treatments: 1.25 mg of bevacizumab (group 1, n = 9), 0.7 mg of dexamethasone as an implant (group 2, n = 12), or a combination of 2 mg of triamcinolone acetonide and 1.25 mg of bevacizumab (group 3, n = 9). Measurements of visual acuity and central macular thickness (CMT) with optical coherence tomography were performed at baseline, and at 1 and 3 months injection.
Results: Compared to baseline, the CMT was significantly decreased in all groups by 326.32 ± 149.32, 311.50 ± 58.54, and 282 ± 28.21, respectively, at 1 month and 407 ± 160, 348 ± 108, and 289 ± 66, respectively, at 3 months, but there was no significant difference within each group. Compared to baseline, best-corrected visual acuity (BCVA) was significantly increased in all groups at 1 month and 3 months. Using post hoc analysis, there was no significant difference in the degrees of BCVA gain, but in degrees of CMT reduction, groups 2 and 3 were significantly higher than group 1 at 1 month and only group 3 was significantly higher than group 1 at 3 months (p < 0.017).
Conclusions: The intravitreal injection of bevacizumab, a dexamethasone implant, or a combination of triamcinolone-bevacizumab could be effectively used in the treatment of ME due to BRVO. For ME, steroid treatment showed a greater reduction percentage, and in the case of the triamcinolone-bevacizumab combination, we could cover the short half-life of bevacizumab and the complications of steroid use. In severe cases of ME, an intravitreal dexamethasone implant or a combination of triamcinolone and bevacizumab can be considered as the first-line therapy.
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KEYWORD
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Bevacizumab, Branch retinal vein occlusion, Dexamethasone implant, Triamcinolone
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