PURPOSE: To compare the efficacy of intravitreal injection of triamcinolone, bevacizumab, and a combination of triamcinolone-bevacizumab for the management of macular edema due to branch retinal vein occlusion. METHODS:Fifty-two eyes of 52 patients (29 male, 23 female) with branch retinal vein occlusion and macular edema were included. Patients received one of the following intravitreal treatments: 4 mg triamcinolone acetonide monotherapy (n=17), 1.25 mg bevacizumab monotherapy (n=14) or a combination of 2 mg triamcinolone acetonide and 1.25 mg bevacizumab (n=21). Measurements of Snellen visual acuity and central macular thickness with optical coherence tomography were done at baseline, and at months one, three, and six. RESULTS: At baseline, the three groups did not differ in age (P=0.12), duration of macular edema (P=0.24), visual acuity (P=0.62), central macular thickness (P=0.16), and intraocular pressure (P=0.15). All study groups showed significant reduction of central macular thickness (P=0.02, P=0.02, and P=0.001, respectively) and improvement in visual acuity (P=0.02, P= 0.02 and P=0.02, respectively) one month after injection. At six months, there was a significant reduction in central macular thickness (P=0.02, P=0.02, and P=0.04, respectively) while only bevacizumab monotherapy group demonstrated significant improvement in visual acuity (P=0.01). CONCLUSION: Intravitreal injection of triamcinolone, bevacizumab or combination of triamcinolone-bevacizumab appears to have similar therapeutic effects on macular edema due to branch retinal vein occlusion at one month. Intravitreal injection of bevacizumab yielded better results of visual acuity than the others at six months.
RCT Entities:
PURPOSE: To compare the efficacy of intravitreal injection of triamcinolone, bevacizumab, and a combination of triamcinolone-bevacizumab for the management of macular edema due to branch retinal vein occlusion. METHODS: Fifty-two eyes of 52 patients (29 male, 23 female) with branch retinal vein occlusion and macular edema were included. Patients received one of the following intravitreal treatments: 4 mg triamcinolone acetonide monotherapy (n=17), 1.25 mg bevacizumab monotherapy (n=14) or a combination of 2 mg triamcinolone acetonide and 1.25 mg bevacizumab (n=21). Measurements of Snellen visual acuity and central macular thickness with optical coherence tomography were done at baseline, and at months one, three, and six. RESULTS: At baseline, the three groups did not differ in age (P=0.12), duration of macular edema (P=0.24), visual acuity (P=0.62), central macular thickness (P=0.16), and intraocular pressure (P=0.15). All study groups showed significant reduction of central macular thickness (P=0.02, P=0.02, and P=0.001, respectively) and improvement in visual acuity (P=0.02, P= 0.02 and P=0.02, respectively) one month after injection. At six months, there was a significant reduction in central macular thickness (P=0.02, P=0.02, and P=0.04, respectively) while only bevacizumab monotherapy group demonstrated significant improvement in visual acuity (P=0.01). CONCLUSION: Intravitreal injection of triamcinolone, bevacizumab or combination of triamcinolone-bevacizumab appears to have similar therapeutic effects on macular edema due to branch retinal vein occlusion at one month. Intravitreal injection of bevacizumab yielded better results of visual acuity than the others at six months.
Authors: Edith Poku; John Rathbone; Ruth Wong; Emma Everson-Hock; Munira Essat; Abdullah Pandor; Allan Wailoo Journal: BMJ Open Date: 2014-07-17 Impact factor: 2.692