Comparison of Clinical Efficacy of Intravitreal Ranibizumab with and without Triamcinolone Acetonide in Macular Edema Secondary to Central Retinal Vein Occlusion

Abstract

Purpose: To compare visual outcomes and spectral-domain optical coherence tomography results following treatment with intravitreal ranibizumab (IVR) or IVR combined with intravitreal triamcinolone acetonide (IVTA) for macular edema (ME) secondary to central retinal vein occlusion (CRVO).Methods: This prospective, case-controlled study examined 57 eyes (57 patients) with ME secondary to CRVO, which were treated with IVR (0.5 mg, n = 30 eyes) or IVR (0.5 mg) and IVTA (1 mg, n = 27 eyes) as the initial therapy. Further intravitreal treatment was administered as necessary.Results: All 57 patients completed at least 6 months of follow-up. At baseline, mean ( ± standard error) best-corrected visual acuity (BCVA) was 45.8 ± 23.2 letters in the IVR group and 47.3 ± 19.3 letters in the IVR + IVTA group (p = 0.790). Significant improvement in BCVA over baseline was observed in both groups at all six study visits (IVR group: p = 0.0003, 0.0001, 0.0018, 0.0145, 0.0107, 0.005; IVR + IVTA group: p = 0.0001, 0.0001, 0.0004, 0.0068, 0.0007, 0.0002), with no significant BCVA differences between groups. Significant reduction in mean central subfield thickness, compared with baseline, was also observed in both groups at all six study visits (IVR group, p = 0.0001; IVR + IVTA group, p = 0.0001), with no significant difference between groups in the magnitude of macular thickness reduction. The mean number of injections was significantly higher (p = 0.0001) in the IVR group (4.23 ± 0.56) than in the IVR + IVTA group (3.42 ± 0.41).Conclusions: Treating ME secondary to CRVO with IVR or IVR + IVTA had similar effects on central macular thickness and BCVA in patients with ME secondary to CRVO over a 6-month follow-up period. The mean number of intravitreal injections was higher in the IVR group than in the IVR + IVTA group.