Intravitreal triamcinolone acetonide versus bevacizumab therapy for macular edema associated with branch retinal vein occlusion. 2010

Yeo Jue Byun, and Mi In Roh, and Sung Chul Lee, and Hyoung Jun Koh
The Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, 134 Shinchon-dong, Sodaemoon-gu, Seoul, 120-752, Korea.

OBJECTIVE To compare visual outcomes after intravitreal triamcinolone acetonide (IVTA) injection and intravitreal bevacizumab (IVB) administration for treatment of macular edema associated with branch retinal vein occlusion (BRVO). METHODS A retrospective comparative case series of 134 consecutive patients that were treated with either IVTA or IVB for macular edema caused by BRVO. Visual acuity at baseline and 1, 3, 6, 9, and 12 months, and central macular thickness measured by OCT at baseline and 1, 3, 6, and 12 months. The time to recurrence of macular edema after treatment was also analyzed. RESULTS Visual acuity (Snellen equivalent) improved significantly from 0.87 logMAR (0.14) to 0.49 logMAR (0.33) in the IVTA group, and from 0.91 logMAR (0.13) to 0.45 logMAR (0.36) in the IVB group 12 months after injection (p < 0.001). Central macular thickness decreased significantly from 491.0 microm to 255.8 microm in the IVTA group, and from 477.4 microm to 218.9 microm in the IVB group 12 months after injection (p < 0.001). In between-group comparisons, neither visual acuity (p = 0.892) nor macular thickness (p = 0.612) improvements were statistically significantly different. In the IVTA-all group, recurrence of macular edema occurred in 7.6% of patients at a mean of 12.6 months postoperatively, and the average number of injections was 1.08. In the IVB-all group, 26.0% of patients suffered recurrences at a mean of 5.3 months after treatment, and received a mean of 1.89 injections. Recurrence was more frequent in the IVB group compared to the IVTA group (Kaplan-Meier survival analysis log-rank test, p < 0.0001). CONCLUSIONS IVTA and IVB injections were similarly effective for improving visual acuity in patients with macular edema secondary to BRVO. However, the IVTA group showed longer mean improvement duration and less disease recurrence, and required fewer injections than the IVB group.

UI MeSH Term Description Entries
D007166 Immunosuppressive Agents Agents that suppress immune function by one of several mechanisms of action. Classical cytotoxic immunosuppressants act by inhibiting DNA synthesis. Others may act through activation of T-CELLS or by inhibiting the activation of HELPER CELLS. While immunosuppression has been brought about in the past primarily to prevent rejection of transplanted organs, new applications involving mediation of the effects of INTERLEUKINS and other CYTOKINES are emerging. Immunosuppressant,Immunosuppressive Agent,Immunosuppressants,Agent, Immunosuppressive,Agents, Immunosuppressive
D008269 Macular Edema Fluid accumulation in the outer layer of the MACULA LUTEA that results from intraocular or systemic insults. It may develop in a diffuse pattern where the macula appears thickened or it may acquire the characteristic petaloid appearance referred to as cystoid macular edema. Although macular edema may be associated with various underlying conditions, it is most commonly seen following intraocular surgery, venous occlusive disease, DIABETIC RETINOPATHY, and posterior segment inflammatory disease. (From Survey of Ophthalmology 2004; 49(5) 470-90) Central Retinal Edema, Cystoid,Cystoid Macular Edema,Macular Edema, Cystoid,Cystoid Macular Dystrophy,Cystoid Macular Edema, Postoperative,Irvine-Gass Syndrome,Macular Dystrophy, Dominant Cystoid,Edema, Cystoid Macular,Edema, Macular,Irvine Gass Syndrome,Syndrome, Irvine-Gass
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D005260 Female Females
D005500 Follow-Up Studies Studies in which individuals or populations are followed to assess the outcome of exposures, procedures, or effects of a characteristic, e.g., occurrence of disease. Followup Studies,Follow Up Studies,Follow-Up Study,Followup Study,Studies, Follow-Up,Studies, Followup,Study, Follow-Up,Study, Followup
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000068258 Bevacizumab An anti-VEGF humanized murine monoclonal antibody. It inhibits VEGF RECEPTORS and helps to prevent PATHOLOGIC ANGIOGENESIS. Avastin,Bevacizumab-awwb,Mvasi,Bevacizumab awwb
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly

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