Grid Laser Photocoagulation After Intravitreal Triamcinolone for Macular Edema Associated With Branch Retinal Vein Occlusion

Abstract

Purpose: To evaluate the clinical outcomes of macular laser photocoagulation after intravitreal injection of triamcinolone acetonide (IVTA) for macular edema in branch retinal vein occlusion (BRVO). Methods: In this retrospective study we reviewed the medical records of patients who had been treated with an intravitreal injection of 4 mg triamcinolone acetonide for macular edema due to BRVO and followed up for more than six months. We divided the eyes into two groups, namely, the IVTA-only group and the additional grid laser group after IVTA. Visual acuity, macular thickness, intraocular pressure, and abundance of IVTA were compared. Results: A total of 41 eyes underwent IVTA, 21 of which were treated with additional macular grid photocoagulation. The difference in best corrected visual acuity before IVTA between the two groups was not statistically significant. Laser photocoagulation was performed at an average of 2.8 months after IVTA. Final VA and foveal thickness improved significantly after IVTA in both groups and showed no significant difference between the two groups. After six months a second injection was required in six eyes in the IVTA group and one eye in the photocoagulation group due to recurrence of macular edema, the difference of which was significant (p=0.04). Conclusions: IVTA in BRVO patients improved macular edema and visual acuity. Combined grid photocoagulation after IVTA lowered the recurrence rate of macular edema. Grid photocoagulation can be considered as a useful adjuvant for avoiding repeated administration of intravitreal triamcinolone.