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Cho, Choi, Rhee, and Lee: Combined Therapy of Intravitreal Bevacizumab and Posterior Subtenon Triamcinolone Injection in Macular Edema with Branch Retinal Vein Occlusion
Original Article
Journal of the Korean Ophthalmological Society

Journal of the Korean Ophthalmological Society 2012; 53(2): 276-282.

Published online: 15 February 2012

DOI: https://doi.org/10.3341/jkos.2012.53.2.276

Combined Therapy of Intravitreal Bevacizumab and Posterior Subtenon Triamcinolone Injection in Macular Edema with Branch Retinal Vein Occlusion

Aran Cho, MD1, Kyung Seek Choi, MD, PhD1, Mi Ri Rhee, MD2, Sung Jin Lee, MD, PhD1

1Department of Ophthalmology, Soonchunhyang University College of Medicine, Seoul, Korea.

2Myeong Eye Clinic, Seoul, Korea.

Address reprint requests to Sung Jin Lee, MD, PhD. Department of Ophthalmology, Soonchunhyang University Hospital, #59 Daesagwan-ro, Yongsan-gu, Seoul 140-743, Korea. Tel: 82-2-709-9354, Fax: 82-2-798-7797, wismile@unitel.co.kr

Received 12 August 2011       Accepted 19 January 2012

Copyright © 2012 The Korean Ophthalmological Society

Abstract

Purpose

To compare the clinical outcomes of intravitreal bevacizumab with and without posterior subtenon triamcinolone acetonide injections for macular edema with branch retinal vein occlusion.

Methods

Intravitreal bevacizumab injection (single group) or intravitreal bevacizumab injection with posterior subtenon triamcinolone acetonide injection (combined group) were performed in 30 eyes each, and intravitreal bevacizumab injection was given once a month in both groups until macular edema was in the normal range. A best corrected visual acuity and central macular thickness were measured pre- and post-injection.

Results

The required number of injections to achieve improved macular edema in the normal range was 2.8 ± 0.5 times in the single group and 2.0 ± 0.6 times in the combined group. Six months after injection, average central macular thickness decreased to 185.3 ± 63.5 µm in the single group and to 260.0 ± 74.6 µm in the combined group. The best corrected visual acuity (log MAR) improved from 0.71 ± 0.63 to 0.35 ± 0.44 in the single group and from 0.67 ± 0.42 to 0.08 ± 0.11 in the combined group. The number of cases in which the central macular thickness increased again within 6 months after the injections was 19 eyes in the single group and 6 eyes in the combined group.

Conclusions

In macular edema with branch retinal vein occlusion, early rapid recovery of visual acuity and decrease of central macular thickness were observed due to the synergistic effect of bevacizumab and triamcinolone acetonide in combined therapy, and the recurrence frequency of macular edema was reduced by the long-term effect instilled by the long half-life of triamcinolone acetonide.

Keywords: Bevacizumab, Branch retinal occlusion, Combined therapy, Macular edema, Triamcinolone

Figures and Tables

Figure 1
The changed of mean visual acuity (log MAR) of bevacizumab group and combined group in patients with macular edema associated with branch retinal vein occlusion.
jkos-53-276-g001
Figure 2
The changes of central macular thickness of triamcinolone group and bevacizumab group in patients with macular edema associated with branch retinal vein occlusion.
jkos-53-276-g002
Table 1
Baseline profiles of BRVO patients treated by intravitreal bevacizumab or bevacizumab with posterior sub-Tenon triamcinolone
jkos-53-276-i001

BCVA = best corrected visual acuity; CMT = central macular thickness; ME = macular edema.

*Intravitreal bevacizumab.

Table 2
Change of visual acuity and central macular thickness
jkos-53-276-i002

Values are presented as mean ± SD.

BCVA = best corrected visual acuity; CMT = central macular thickness.

*Intravitreal bevacizumab.

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