Triamcinolone acetonide with vitrectomy for treatment of macular edema associated with branch retinal vein occlusion.
OBJECTIVE
To review the efficacy of a combination of triamcinolone acetonide (TA) injection and pars plana vitrectomy (PPV) for the treatment of macular edema associated with branch retinal vein occlusion (BRVO).


METHODS
Seventeen eyes with macular edema associated with BRVO underwent PPV with an intraoperative injection of TA (10 mg) into the vitreous cavity. Residual or recurrent macular edema was treated with postoperative sub-Tenon capsule injections of TA (20 mg).


RESULTS
With PPV and an intraoperative injection of TA, 82% of eyes showed rapid reduction of macular edema; foveal thickness decreased from 507 +/- 115 microm preoperatively to 261 +/- 123 microm 2 months after surgery (P = 0.0041). However, 59% of eyes showed recurrence of macular edema during the follow-up period. Twelve eyes with residual or recurrent macular edema received sub-Tenon capsule injections of TA; of these eyes, 9 showed substantial reduction of macular edema. Foveal thickness decreased from 381 +/- 102 microm to 256 +/- 56 microm (P = 0.0076) 2 weeks after postoperative injections of TA. At the final visit, visual acuity (logMAR) improved from 0.74 +/- 0.40 preoperatively to 0.40 +/- 0.34 (P = 0.010).


CONCLUSIONS
An intraoperative injection of TA in combination with PPV has the potential to facilitate the absorption of macular edema associated with BRVO. In addition, residual or recurrent macular edema can be treated with additional sub-Tenon capsule injections of TA.
Tsujikawa
Akitaka
A
Department of Ophthalmology, Kobe City General Hospital, Kobe, Japan. tujikawa@kuhp.kyoto-u.ac.jp
Fujihara
Masashi
M
Iwawaki
Takuji
T
Yamamoto
Kaoruko
K
Kurimoto
Yasuo
Y
D000368:Aged; D003131:Combined Modality Therapy; D005260:Female; D005938:Glucocorticoids / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D007267:Injections; D007430:Intraoperative Care; D008269:Macular Edema / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D012170:Retinal Vein Occlusion / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D014222:Triamcinolone Acetonide / Q000009:adverse effects / Q000627:therapeutic use*; D014792:Visual Acuity; D014821:Vitrectomy / Q000379:methods*; D014822:Vitreous Body
D005938:Glucocorticoids; D014222:Triamcinolone Acetonide