Comparision of intravitreal triamcinolone acetonide for macular edema secondary to retinal vein occlusion and diabetic retinopathy

Abstract

Objective To observe the comparison of the therapeutic efficacy of intravitreal of triamcinolone acetonide (TA) for macular edema caused by retinal vein occlusion (RVO) and diabetic retinopathy (DR). Methods TA was injected inttravitreally in 91 eyes of 91 patients with macular edema secondary to RVO and 73 eyes of 67 patients secondary to DR determined by indirect ophthalmoscope, fundus fluorescent angiography (FFA) and optic coherence tomography (OCT). Among the RVO patients, CRVO were 55 eyes (ischemic type was 11 eyes, and 42 eyes were non-ischemic type). BRVO were 36 eyes (ischemic type was 10 eyes, and 26 eyes were non-ischemic type). Among the DR patients, pre-proliferative diabetic retinopathy (PPDR) were 17 eyes and proliferative diabetic retinopathy (PDR) were 56 eyes. The visual acuity, fundus findings, FFA and the macular thickness under the OCT were recorded and analyzed prior to operation and after operation. Follow-up time was 3 months to 1 years. Results In the group of RVO, visual acuity was improved at the end of follow-up in 48 (52.7%) eyes and decreased or unchanged in 4 (4.40%) eyes and 39 (42.9%) eyes, respectively. 50 (54.9%) eyes showed normal macular thickness after injection of TA on OCT. Improved fundus appearance was seen in 27 (29.7%) eyes on OCT. The fundus was unchanged or even worse in 14 (15.4%) eyes on OCT at the last visit. In the group of DR, visual acuity was improved at the end of follow-up in 25 (34.2%) eyes and decreased or unchanged in 3 (4.11%) eyes and 45 (61.6%) eyes, respectively. 24 (32.9%) eyes showed normal macular thickness after injection of TA on OCT. Improved fundus appearance was seen in 22 (30.1%) eyes on OCT. The fundus was unchanged or even worse in 27 (37.0%) eyes on OCT at the last visit. The difference of two groups was significant. In the group of RVO, intraocular pressure was elevated in 24 eyes. Cataract was in 1 eye and endophthalmitis in 1 eye. 8 eyes were injected two times. In the group of DR, intraocular pressure was elevated in 14 eyes. Cataract was in 2 eyes. 9 eyes were injected two times. Conclusions Intravitreal injection of TA is a safe and effective method to the treatment of macular edema secondary to RVO and DR. The therapeutic efficacy for RVO is better than for DR. Key words: Triamcinolone acetonide; Retinal vein occlusion; Diabetic retinopathy; Macular edema; Optic coherence tomography