Session Title: Quick Fire Free Paper 5
Session Date/Time: Sunday 14/09/2014 | 11:00-13:00
Paper Time: 12:30
Venue: Boulevard B
First Author: : S.Mishra INDIA
Co Author(s): : A. Gupta J. Parihar R. Maggon S. Kumar A. Singh
To compare between intravitreal Dexamethasone(0.7 mg) (Ozurdex) and intravitreal Triamcinolone acetonide(4mg) in patients suffering from Central Retinal Vein Occlusion (CRVO) in terms of their efficacy and safety
Army Hospital (Research and Referral ) Delhi Cantt, New Delhi , India
Patients diagnosed as CRVO of recent onset (less than 3 months) were randomized to receive intravitreal dxamethasone(0.7 mg) and kenacort(4 mg). A complete baseline evaluation was done before treatment. They were followed up at 4,8,12 and 24 months after treatment. The response to treatment was monitored anatomically by measuring CMT using OCT, and, functionally, by best-corrected visual acuity (BCVA). Potential corticosteroid- induced and injection-related complications were also recorded. The patient’s baseline and follow-up variables were compared between the groups and appropriate tests were used to determine the statistical differences between the groups.
After a single administration, the time to achieve a 15 letter improvement in BCVA and the percentage of eyes with 15 letter improvement in BCVA were similar in both Dexamethasone and Triamcinolone groups. The Dexamethasone implant treated eyes showed a rise in intraocular pressure (IOP) of 3 mmHg in 10% of patients which peaked at day 50. It was well controlled with a single antigalucoma eye drop. The triamcinolone treated group showed a greater rise in IOP of 8 mmHg in 65% of patients which peaked at day 30 and required a combination of 2 drugs. 8% patients of triamcinolone treated group developed cataract and required cataract surgery compared to none in the dexamethasone treated group.
Dexamethasone intravitreal implant and triamcinolone have similar efficacy in reducing the risk of vision loss and improving the speed and incidence of visual improvement in eyes with macular oedema secondary to CRVO. Visual morbidity in the terms of IOP rise and incidence of cataract is greater in triamcinolone group. Dexamethasone has a higher safety profile and thus is a preferred option between the two.