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ONE-YEAR SAFETY AND EFFICACY OF INTRAVITREAL TRIAMCINOLONE ACETONIDE FOR THE MANAGEMENT OF MACULAR EDEMA SECONDARY TO CENTRAL RETINAL VEIN OCCLUSION

2006; Lippincott Williams & Wilkins; Volume: 26; Issue: 8 Linguagem: Inglês

10.1097/01.iae.0000237111.82357.30

1539-2864

Ninel Z. Gregori, Philip J. Rosenfeld, Carmen A. Puliafito, Harry W. Flynn, Ji Eun Lee, Elias C. Mavrofrides, William E. Smiddy, Timothy G. Murray, Audina M. Berrocal, Ingrid U. Scott, Giovanni Gregori,

Retinal Imaging and Analysis

In Brief Purpose: To evaluate the safety and efficacy of intravitreal triamcinolone acetonide (IVTA) as treatment for macular edema associated with central retinal vein occlusion (CRVO). Methods: A retrospective review was performed of data for 40 consecutive patients (40 eyes) with CRVO and macular edema treated with IVTA at the Bascom Palmer Eye Institute (Miami, FL). Results: Median duration of symptoms before the first injection was 3 months (range, 1 day to 8 years). Median Snellen visual acuity was 20/400 at baseline (range, 20/60 to light perception; n = 40), 20/300 at 1 month (P = 0.010; n = 37), 20/300 at 3 months (P = 0.007; n = 33), 20/400 at 6 months (P = 0.726; n = 28), and 8/200 at 1 year (P = 0.569; n = 17). Vision improved by ≥3 lines in 21% of eyes at 1 month, 27% at 3 months, 14% at 6 months, and 12% at 1 year. Visual acuity was unchanged from baseline in 71% of eyes at 6 months and 1 year. By 1 year, 50% of eyes received more than one injection (mean = 1.6 injections; range 1–4 injections). Overall, intraocular pressure increased by ≥10 mmHg in 24% of eyes at 1 year. Trabeculectomy was performed on 2 of 12 eyes with preexisting open-angle glaucoma. Conclusion: IVTA can substantially improve vision in some patients, but most patients have stable visual acuity compared with baseline at 1 year despite repeated injections. Intravitreal triamcinolone acetonide may be associated with substantially improved vision in some patients, but this benefit is generally not sustained, with 71% of eyes having unchanged visual acuity from baseline at 1 year despite repeated injections.