Intravitreal triamcinolone acetonide injection for macular edema due to central retinal vein occlusion persisting despite multiple intravitreal bevacizumab injections

Abstract

Purpose: 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. © 2014 Mary Ann Liebert, Inc.