J Korean Ophthalmol Soc.  2019 Nov;60(11):1072-1079. 10.3341/jkos.2019.60.11.1072.

Comparison of Short-term Effects of Intravitreal Injection of Three Modalities on Central Retinal Vein Occlusion

• Jeong JS
• Lee DW
• Kim BS
• Yoo WS
• Chung IY
• Park JM

• KMID: 2463358
• DOI: http://doi.org/10.3341/jkos.2019.60.11.1072

Abstract

PURPOSE
To report the short-term effects of intravitreal bevacizumab alone, low-dose bevacizumab combined with low-dose triamcinolone injection, and intravitreal dexamethasone implant (Ozurdex®, Allergan, Irvine, CA, USA) injection in patients with macular edema following central retinal vein occlusion (CRVO).
METHODS
The medical records of 70 patients (70 eyes) with macular edema secondary to CRVO were reviewed retrospectively. Of these, 25 eyes (IVB group) were injected with intravitreal bevacizumab, 23 eyes (intravitreal low-dose bevacizumab and triamcinolone injection [IVB+IVTA] group) were injected with low-dose bevacizumab (0.625 mg/0.025 mL) combined with low-dose triamcinolone (1 mg/0.025 mL), and 20 eyes (intravitreal dexamethasone implant [IVD] group) were injected with an intravitreal dexamethasone implant. The best-corrected visual acuity (BCVA), central macular thickness (CMT), and intraocular pressure (IOP) of treated eyes were measured before injection and at 1 month and 3 months after injection.
RESULTS
Groups were similar in age and gender distribution. At 1 month, the CMT of all groups was significantly lower, and the BCVA of all groups had increased significantly in patients with CRVO; there were no significant differences among the three groups (p = 0.246, p = 0.974). At 3 months, the CMT and BCVA had improved significantly only in the IVD and IVB+IVTA groups; the short-term effect was comparable to the IVD group. IOP showed no significant change at 3 months after injection for all groups.
CONCLUSIONS
Considering various clinical variables in the treatment of macular edema associated with CRVO, intravitreal injection of bevacizumab, low-dose bevacizumab combined with triamcinolone, and dexamethasone implants may be used selectively.

Keyword

Bevacizumab; Dexamethasone; Intravitreal injections; Retinal vein occlusion; Triamcinolone

MeSH Terms

Bevacizumab
Dexamethasone
Humans
Intraocular Pressure
Intravitreal Injections*
Macular Edema
Medical Records
Retinal Vein Occlusion
Retinal Vein*
Retrospective Studies
Triamcinolone
Visual Acuity
Bevacizumab
Dexamethasone
Triamcinolone

Figure

• 

  Figure 1 Changes of central macular thickness (CMT) among study groups during 3 months of follow up period. The CMT of all groups was decreased at postoperative 1 month and 3 months compared with baseline. IVB = intravitreal bevacizumab injection; IVB + IVTA = intravitreal low-dose bevacizumab and triamcinolone injection; IVD = intravitreal dexamethasone implant.

• 

  Figure 2 Comparison of central macular thickness (CMT) among study groups at postoperative 3 months. Note that the CMT of IVB group was increased significantly more than IVD and IVB+IVTA groups. IVB = intravitreal bevacizumab injection; IVB + IVTA = intravitreal low-dose bevacizumab and triamcinolone injection; IVD = intravitreal dexamethasone implant; Mo = month(s).

• 

  Figure 3 Changes of visual acuity among study groups during 3 months of follow up period. At postoperative 1 month, the best corrected visual acuity (BCVA) of all groups was increased significantly. At postoperative 3 months, the BCVA was significantly improved only in the intravitreal dexamethasone implant group compared with baseline. logMAR = logarithm of the minimal angle of resolution; IVB = intravitreal bevacizumab injection; IVB + IVTA = intravitreal low-dose bevacizumab and triamcinolone injection.

• 

  Figure 4 Changes of intraocular pressure (IOP) among study groups during 3 months of follow up period. The IOP showed no significant change at postoperative 3 months after injection in all three groups. IVB = intravitreal bevacizumab injection; IVB + IVTA = intravitreal low-dose bevacizumab and triamcinolone injection; IVD = intravitreal dexamethasone implant.

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