Journal List > J Korean Ophthalmol Soc > v.60(11) > 1137323

Jeong, Lee, Kim, Yoo, Chung, and Park: Comparison of Short-term Effects of Intravitreal Injection of Three Modalities on Central Retinal Vein Occlusion

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.

Figures and Tables

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.

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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).

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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.

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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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Table 1

Baseline and demographic characteristics

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Values are presented as mean ± standard deviation or number (%) unless otherwise indicated.

IVB = intravitreal bevacizumab injection; IVB+IVTA = intravitreal low-dose bevacizumab and triamcinolone injection; IVD = intravitreal dexamethasone implant; M:F = male:female; FA = fluorescein angiography; IVI = intravitreal injection; DM = diabetes mellitus; HTN = hypertension; CMT = central macular thickness; BCVA = best-corrected visual acuity; logMAR= logarithm of the minimal angle of resolution; IOP = intraocular pressure.

*Kruskal-Wallis test.

Table 2

Comparison of CMT in the three groups

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Values are presented as mean ± standard deviation.

IVB = intravitreal bevacizumab injection; IVB + IVTA = intravitreal low-dose bevacizumab and triamcinolone injection; IVD = intravitreal dexamethasone implant; CMT = central macular thickness; Post-op = postoperative.

*Kruskal-Wallis test; p-value compared with baseline, Wilcoxon signed rank test.

Table 3

Comparison of visual acuity in the three groups

jkos-60-1072-i003

Values are presented as mean ± standard deviation.

IVB = intravitreal bevacizumab injection; IVB + IVTA = intravitreal low-dose bevacizumab and triamcinolone injection; IVD = intravitreal dexamethasone implant; BCVA = best corrected visual acuity; logMAR = logarithm of the minimal angle of resolution; Post-op = postoperative.

*Kruskal-Wallis test; p-value compared with baseline, Wilcoxon signed rank test.

Table 4

Comparison of IOP in the three groups

jkos-60-1072-i004

Values are presented as mean ± standard deviation.

IOP = intraocular pressure; IVB = intravitreal bevacizumab injection; IVB + IVTA = intravitreal low-dose bevacizumab and triamcinolone injection; IVD = intravitreal dexamethasone implant; Post-op = postoperative.

*Kruskal-Wallis test; p-value compared with baseline, Wilcoxon signed rank test.

Notes

Conflicts of Interest The authors have no conflicts to disclose.

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