Intravitreal Triamcinolone for the Management of Macular Edema Dueto Nonischemic Central Retinal Vein Occlusion

Open Access
Publisher Website
Google Scholar
Abstract
Objective To evaluate the efficacy of intravitreal triamcinolone acetonide inthe management of persistent macular edema secondary to nonischemic centralretinal vein occlusion (CRVO). Methods Twenty consecutive patients were selected with a 3- to 4-month historyof nonischemic CRVO and persistent macular edema. These patients receiveda single intravitreal injection of 4 mg of triamcinolone acetonide (40 mg/mL).The follow-up period ranged from 10 to 12 months. The amount of macular edemawas assessed by the amount of retinal thickening on clinical examination usingthe Goldmann contact lens and by the area and intensity of staining on fluoresceinangiography. Treated patients were compared with a retrospectively matchedgroup of patients who were managed with observation only. Main Outcome Measures Changes in visual acuity and amount of macular edema were assessed inthe treated patients and compared with the observation group. Results The mean baseline visual acuity in the treatment group was 20/132 vs20/123 for the observation group (P = .57). After1 week, the treated group had a mean visual acuity of 20/51. At final follow-up,the treated group had a mean visual acuity of 20/37 while the observationgroup had a mean visual acuity of 20/110 (P = .001).Sixty percent of treated patients had a final visual acuity of 20/40 or bettervs only 20% in the observation group (P = .01). Fortypercent of the untreated patients had a final visual acuity worse than 20/200while none of the treated patients did (P<.001).At final follow-up, 75% of treated patients had complete resolution of macularedema on clinical examination vs only 20% of the untreated patients (P<.001). Two of the treated patients had recurrenceof macular edema at 6 months, and 3 had elevated intraocular pressure. Conclusion This study shows a treatment benefit from intravitreal triamcinolonein terms of visual acuity and macular edema for nonischemic CRVO.