First Author: R.Fayzrakhmanov RUSSIA
Co Author(s): M. Bikbov
Back to previous
To assess changes in central retina on the background of intravitreal injection of triamcinolone acetonide (TA) in patients with macular edema, secondary retinal vein occlusion.
Ufa Eye Research Institute, Ufa, Russia
We examined 26 patients (26 eyes) including patients with central retinal vein occlusion (9 eyes) – group 1, or branch retinal vein occlusion (17 eyes) – group 2. Mean age of patients is 60.8±2.1 years, of which there are 15 women and 11 men. Duration of disease was 1.8±0.3 months, on average. Control group included 23 paired eyes of patients with no concurrent eye diseases except angiopathy. Patients underwent single intravitreal injection of 0.1 ml (4 mg) using standard technique. Follow-up period totalled 1 month.
In the control group the best corrected visual acuity (BCVA) equalled 0.94±0.06, total light sensitivity – 19.7±0.3 dB, mean retinal thickness at foveola – 224.5±5.38 µm, total retinal thickness of investigated area of macula equalled 299.41 ±3.73 mm, including the outer layer - 165.89 ± 2.87 µm, inner layer – 132.77 ± 2.26 mm (in a ratio of 0.55 / 0.45). In one month after the injection of TA patients in group I noticed improvement in BCVA from 0.04±0.02 to 0.16 ± 0.08 (in comparison with the control group, p <0.05), and group II – with 0.14 ± 0.03 to 0.5 ± 0.16 (in comparison with results before treatment, p <0.05), total light sensitivity of macular area averaged 1.34 ± 1.11 to 3.63 ± 3.03 dB and 7.35 ± 1.89 to 8.98 ± 1.54 dB. Respectively OCT showed a significant (2.6 times) decrease in macular edema (856.76 ± 101.92 to 336.46 ± 29.45 mm, p <0.05) in group I and 1.8 times – in group II (566.46 ± 51.51 to 324.74 ± 21.43 mm, p <0.05).
The ratio of the thickness of outer and inner retinal layers in group I was 0.52/0.43, in the 2 – 0.55 / 0.45. In general, complete resorption of macular edema was observed in 10 patients (76, 9%), 1 patient (7.7%) with central retinal vein occlusion maintained a small detachment of the neuroepithelium, 2 patients (15.4%) with thrombosis of its branches maintained single cysts in the outer nuclear layer.Analysis of visometry in examined patients due to duration of the treatment after the onset of the disease showed significant improvement in visual acuity, compared with the results before the treatment (with 0,14 ± 0,04 to 0,58 ± 0,14, p <0,05 ) after up to 2 months of intravitreal injections of TA.Intravitreal injection of TA improves visual function in patients with retinal vein occlusions, contributes to partial normalization of central retina profile, mainly due to significant changes in the thickness of outer retinal layers in all types of occlusion. Intravitreal injection of TA in early stages (up to 2 months after occlusion) helps to achieve higher levels of visual acuity.