title: Simultaneous intravitreal injection of triamcinolone acetonide and tissue plasminogen activator for central retinal vein occlusion: a pilot study.
abstract: OBJECTIVE
  To evaluate the efficacy and safety of simultaneous intravitreal injection of triamcinolone acetonide (TA) and tissue plasminogen activator (tPA) for macular oedema associated with central retinal vein occlusion (CRVO).
  
  
  METHODS
  Twenty eyes of 20 patients with CRVO were enrolled. A mixture of TA (4 mg) and tPA (25 μg) was injected into the vitreous of 20 eyes with CRVO. Best corrected visual acuity (BCVA) and macular thickness before and 1, 3, 6 and 12 months after the procedure were measured.
  
  
  RESULTS
  The BCVA improved three lines or more in 65%, 55%, 55% and 53% of eyes and the mean macular thickness decreased from 1072 μm to 455, 450, 480 and 409 μm (p<0.001) at 1, 3, 6 and 12 months, respectively. Fifteen (75%) of the 20 eyes required at least one additional injection to prevent a recurrence of macular oedema. The intraocular pressure increased in four eyes.
  
  
  CONCLUSIONS
  Overall, intravitreal injection of the TA/tPA mixture improved the BCVA by three lines or more in at least 50% of eyes and decreased the mean macular thickness at four time points without serious side effects. A randomised clinical trial is necessary to evaluate the efficacy of this treatment.
authors.affiliation: Department of Ophthalmology, Osaka University Graduate School of Medicine, Osaka, Japan.
authors.forename: Takuhiro
authors.initials: T
authors.lastname: Yamamoto
authors.forename: Motohiro
authors.initials: M
authors.lastname: Kamei
authors.forename: Kaori
authors.initials: K
authors.lastname: Sayanagi
authors.forename: Nagakazu
authors.initials: N
authors.lastname: Matsumura
authors.forename: Kentaro
authors.initials: K
authors.lastname: Nishida
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Sakaguchi
authors.forename: Motokazu
authors.initials: M
authors.lastname: Tsujikawa
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Tano
mesh_terms: D004359:Drug Therapy, Combination / Q000379:methods; D005260:Female; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology; D058449:Intravitreal Injections; D008269:Macular Edema / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011446:Prospective Studies; D012170:Retinal Vein Occlusion / Q000188:drug therapy* / Q000503:physiopathology; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage*; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D014222:Triamcinolone Acetonide / Q000008:administration & dosage*; D014792:Visual Acuity / Q000502:physiology
chemical_list: D010959:Tissue Plasminogen Activator; D014222:Triamcinolone Acetonide