First Author: O.Artunay TURKEY
Co Author(s): A. Sengul A. Koytak E. Ayıntap E. Oner 0 0 0 0 0 0 0 0 0
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To compare the safety and efficacy of intravitreal injection of triamcinolone acetonide versus intravitreal dexamethasone implant (IVD; Ozurdex, Allergan, Inc., Irvine, CA) for the treatment of macular edema (ME) assocıated with central retinal vein occlusion (CRVO).
Multicentic tertiary ophthalmic referral centers.
A total of 38 consecutive patients (38 eyes) with ME associated with CRVO were randomized to 2 groups. Nineteen eyes were treated with a single intravitreal injection of 4 mg/0.1 mL triamcinolone acetonide ( IVTA); 19 eyes received a single treatment with IVD 0.7 mg. Changes in visual acuity and central macular thickness obtained using optical coherence tomography were measured during a 6-month follow-up. Potential treatment complications and adverse events were monitored, including increases in intraocular pressure (IOP) and cataract progression during the follow-up period.
Best-corrected visual acuity was significantly improved at 2 weeks and 1, 3, 6 months after injection in both the IVTA and IVD groups. Both IVTA and IVD resulted in significant but transient improvements in central macular thickness. Patients who received IVD treatment appeared to have quicker visual recovery and improved central macular thickness at Week 2 compared with those who received IVTA treatment. The mean (± standard deviation [SD] ) central macular thickness in eyes with IVD was significantly thinner than in the IVTA eyes at 1 month (244±89.7 µm and 298.5±115.8 µm, respectively; P= 0.04) and 6 months (358.3± 53.8 µm and 454.7±87.6 µm, respectively; P = 0.01) after injection. ≥10-mmHg intraocular pressure (IOP) increase from baseline was observed in 10.6% IVD group, 30,4 %IVTA group. Eight patients received topical intraocular pressure lowering medication, and one patient required trabeculectomy and premacular membranes were developed in a patient in the IVTA group. No eyes had IOPs over 30 mmHg in IVD group.
Both IVTA and IVD treatments can effectively improve best-corrected visual acuity and reduce central macular thickness in patients with ME secondary to CRVO without systemic side effects. Our study show that short and long term performance of IVD better than IVTA for the anatomic and functional aspects of improvement tested in this investigation. Both the effect of IVTA and that of IVD were not permanent and yet, IVTA causes more adverse events than IVD.