Intravitreal triamcinolone acetonide injection for macular edema due to central retinal vein occlusion persisting despite multiple intravitreal bevacizumab injections.
OBJECTIVE
To evaluate the response to intravitreal triamcinolone acetonide for macular edema persisting or recurring despite multiple intravitreal bevacizumab (IVB) treatments for central retinal vein occlusion (CRVO).


METHODS
Retrospective interventional case series of 21 eyes with CRVO from 21 patients who were diagnosed with persistent or recurrent macular edema secondary to CRVO and treated with 0.1mL (4mg) intravitreal triamcinolone acetonide (IVTA) after initial treatment with 3 or more IVB injections. Anatomic and visual responses were the study primary outcomes.


RESULTS
Mean logarithm of the minimum angle of resolution visual acuity was 1.19 (20/316) immediately before IVTA injection, and improved to 1.04 (20/219) 1 month after IVTA administration (P=0.003). The mean central macular thickness on optical coherence tomography decreased from 533.4 μm immediately before IVTA to 327.9 μm after IVTA injection (P<0.001). No cases of endophthalmitis, retinal detachment, or neovascularization were noted.


CONCLUSIONS
Intravitreal triamcinolone acetonide appears to improve vision and reduce persistent or recurrent macular edema secondary to CRVO despite multiple bevacizumab injections.
Mid Atlantic Retina, The Retina Service of Wills Eye Institute, Thomas Jefferson University , Philadelphia, Pennsylvania.
Rayan A
RA
Alshareef
Sunir J
SJ
Garg
Jason
J
Hsu
James
J
Vander
Carl
C
Park
Marc J
MJ
Spirn
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D020533:Angiogenesis Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage / Q000627:therapeutic use*; D000068258:Bevacizumab; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage / Q000627:therapeutic use; D006801:Humans; D058449:Intravitreal Injections; D008269:Macular Edema / Q000188:drug therapy* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012170:Retinal Vein Occlusion / Q000150:complications* / Q000188:drug therapy; D012189:Retrospective Studies; D014222:Triamcinolone Acetonide / Q000008:administration & dosage / Q000627:therapeutic use*; D014792:Visual Acuity / Q000187:drug effects
D020533:Angiogenesis Inhibitors; D061067:Antibodies, Monoclonal, Humanized; D005938:Glucocorticoids; D000068258:Bevacizumab; D014222:Triamcinolone Acetonide