The Efficacy of Intravitreal Triamcinolone Acetonide Injection for Macular Edema in Central Retinal Vein Occlusion

Su Yeon Kang; Moon Jeong Choi; Su Jin Yoo; Tae Gon Lee; Soon Hyun Kim

doi:10.3341/jkos.2007.48.9.1227

Journal List > J Korean Ophthalmol Soc > v.48(9) > 1007921

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Kang, Choi, Yoo, Lee, and Kim: The Efficacy of Intravitreal Triamcinolone Acetonide Injection for Macular Edema in Central Retinal Vein Occlusion

Original Article

J Korean Ophthalmol Soc 2007;48(9):1227-1233.

Published online: 30 August 2007

DOI: https://doi.org/10.3341/jkos.2007.48.9.1227

The Efficacy of Intravitreal Triamcinolone Acetonide Injection for Macular Edema in Central Retinal Vein Occlusion

Su Yeon Kang, M.D.¹, Moon Jeong Choi, M.D.¹, Su Jin Yoo, M.D.¹, Tae Gon Lee, M.D.¹, Soon Hyun Kim, M.D., Ph.D.²

¹Myung-Gok Eye Research Institute, Department of Ophthalmology, Konyang University, Kim's Eye Hospital, Seoul, Korea

²Nune Eye Hospital, Seoul, Korea

Address reprint requests to Soon Hyun Kim, M.D., Ph.D., Nune Eye Hospital, #907-16 Daechi-dong, Gangnam-gu, Seoul 135-841, Korea, Tel: 82-2-2086-7770, Fax: 82-2-2086-7894, E-mail: nunekim@hotmail.com

Received 21 July 2006 Accepted 29 May 2007

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To investigate the effect of intravitreal injection of triamcinolone acetonide (IVTA) for the treatment of macular edema in central retinal vein occlusion (CRVO).

Methods

Seventy patients with CRVO and persistent macular edema were included in this retrospective study. Thirty-six eyes of 36 patients received an intravitreal injection of 4 mg (0.1 cc) triamcinolone and 34 eyes of 34 control patients didnot receive an injection. Any differences in visual acuity and foveal thickness were measured and compared between the two groups. The correlation between the change in foveal thickness and visual acuity was also evaluated.

Results

In ischemic CRVO group, the mean difference of visual acuity between the injection and the control groups was not statistically significant (p<0.05) at the initial measurement and at one week, one, three, and six months after the injection. However, in the non-ischemic CRVO group it was not clinically significant (p<0.05) at the initial time, one week or six months after the injection. But it was clinically significant at one months and three months after receiving the injection (p=0.004 and 0.001). The mean difference in foveal thickness was clinically significant (p<0.001). The visual acuity and foveal thickness were correlated in non-ischemic group but not in the ischemic group.

Conclusions

The IVTA appears to be an effective treatment in patients with macular edema associated with CRVO. The visual acuity of patients with non-ischemic CRVO improved temporally after the IVTA injection, but there was no significant improvement in ischemic CRVO group

Keywords: Central retinal vein occlusion, Intravitreal injection, Triamcinolone acetonide, Macular edema

References

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Figure 1.

Average visual acuity in ischemic central retinal vein occlusion group.

Figure 2.

Average visual acuity in non-ischemic central retinal vein occlusion group.

Figure 3.

Correlation of macular edema and visual acuity in IVTA group of ischemic central retinal vein occlusion patients.

Figure 4.

Correlation of macular edema and visual acuity in IVTA group of non-ischemic central retinal vein occlusion patients.

Table 1.

Baseline characteristics

	IVTA group		Control group
	Ischemic	Non-ischemic	Ischemic	Non-ischemic
No. of eyes	20	16	18	16
Male:Female	8:12	4:12	6:12	4:12
Mean age (age)	53.0±13.5	56.3±24.5	59.2±12.1	51.8±10.5
Mean follow-up time (months)	6.4±1.9	7.4±2.6	5.9±0.7	8.4±3.2
Baseline visual acuity (logMAR)	1.16	0.82	1.20	0.75
Hypertention^∗	7	6	4	7
Coronary artery	1	2	3	1
disease^∗
Smoker^∗	4	3	5	3

^∗ : No statistically significant with all characteristics.

Table 2.

Improvement of final visual acuity

	IVTA group (%)		Control group (%)
	Ischemic	Non-ischemic	Ischemic	Non-ischemic
Improved^∗	5/20 (25)	13/16 (81)^†	4/18 (22)	12/16 (75)^†
Unchanged	6/20 (30)	2/16 (13)	5/18 (28)	3/16 (19)
Worsen	9/20 (45)	1/16 (6)	9/18 (50)	1/16 (6)

^∗ : Improved at least two lines with Snellen chart.

^† : No statistically significant difference (P>0.05) in two groups by chi-square test.

Table 3.

Changes of foveal thickness (gm)

	Foveal thickening^† : mean±SD (μm)
	Ischemic (n=20)^∗	Non-ischemic (n=16)^∗
Initial	310±43	307±51
1 week	209±52	187±69
1 month	60±92	23±88
3 month	18±59	4±47
6 month	43±87	15±78

^∗ : Statistically significant difference from initial value (P<0.05) at all time points by paired t-test.

^† : (measured-normal) foveal thickness.

Table 4.

Incidence of neovascularization

	IVTA group (%)		Control group (%)
	Ischemic	Non-ischemic	Ischemic	Non-ischemic
NVI/NVG^† (%)^∗	3 (15)	0 (0)	4 (22)	1 (6)

^∗ : Statistically not significant difference with IVTA and control group by Fisher's exact test.

NVI/NVG^†: neovascularization on iris/neovascular glaucoma.

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