Comparison between Intravitreal Triamcinolone with Grid Laser Photocoagulation versus Bevacizumab with Grid Laser Photocoagulation Combinations for Branch Retinal Vein Occlusion
Purpose. To compare the efficacy of intravitreal triamcinolone (IVT) and intravitreal bevacizumab (IVB), both combined with grid laser photocoagulation (GLP) for macular edema (ME) secondary to branch retinal vein occlusion (BRVO). Methods. Retrospective, comparative study. The newly diagnosed patients with ME secondary to BRVO who were treated with IVT and GLP or IVB and GLP were included. The main outcome measures were changed in the best corrected visual acuity (BCVA) and central retinal thickness (CRT) from the baseline to month 24. Results. Ninety-nine eyes of 99 patients were included. The change in BCVA was not statistically different in any time points between the two groups ( , for all). The change in CRT was not statistically different in any time points between the two groups ( , for all). The mean number of injections at month 24 was in the IVT+GLP group and in the IVB+GLP group ( ). The need for cataract surgery ( ) and secondary glaucoma ( ) occurrence were more common in IVT group. Conclusion. Both treatment modalities were effective in the treatment of ME secondary to BRVO. The number of injections was significantly lower in the IVT group than in the IVB group; however cataract and secondary glaucoma were more frequent in the IVT+GLP group than in the IVB+GLP group. 1. Introduction Branch retinal vein occlusion (BRVO) is the second most common cause of retinal vascular disease following diabetic retinopathy [1–3]. Among the changes that define BRVO, macular edema (ME) is a frequent cause of visual acuity loss [2, 3]. Grid laser photocoagulation (GLP) is the only proven long-term effective therapy for ME secondary to BRVO [3]. In the Branch Vein Occlusion Study, it is shown that GLP results in a significant improvement in vision in 65% of the patients; however, the clinical outcomes are sometimes disappointing [3]. Therefore, during the last decade, several studies support the use of intravitreal pharmacotherapies as adjuncts or alternative treatments to laser photocoagulation [4]. Intravitreal corticosteroid and antivascular growth factor (VEGF) injections have been widely investigated in ME secondary to BRVO. Several reports indicated that intravitreal triamcinolone (IVT) injection is an efficacious therapy to prevent the patients with ME secondary to BRVO from loss of vision and retinal thickening [5–9]. Intravitreal bevacizumab (IVB) injection is another treatment option [10, 11]. As an anti-VEGF agent, intravitreal bevacizumab blocks the effects of VEGF, which include increased vascular permeability and subsequent ME [10, 11]. The
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