Intravitreal Triamcinolone for the Management of Macular Edema Dueto Nonischemic Central Retinal Vein Occlusion | Macular Diseases | JAMA Ophthalmology | JAMA Network
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Clinical Sciences
August 2004

Intravitreal Triamcinolone for the Management of Macular Edema Dueto Nonischemic Central Retinal Vein Occlusion

Author Affiliations

From the Departments of Ophthalmology, American University of Beirut–MedicalCenter, Beirut (Drs Bashshur, Ma'luf, Allam, Haddad, and Noureddin), and theAin Wa Zein Hospital, Shouf (Dr Jurdi), Lebanon. The authors have no relevantfinancial interest in this article.

Arch Ophthalmol. 2004;122(8):1137-1140. doi:10.1001/archopht.122.8.1137

Objective  To evaluate the efficacy of intravitreal triamcinolone acetonide inthe management of persistent macular edema secondary to nonischemic centralretinal vein occlusion (CRVO).

Methods  Twenty consecutive patients were selected with a 3- to 4-month historyof nonischemic CRVO and persistent macular edema. These patients receiveda single intravitreal injection of 4 mg of triamcinolone acetonide (40 mg/mL).The follow-up period ranged from 10 to 12 months. The amount of macular edemawas assessed by the amount of retinal thickening on clinical examination usingthe Goldmann contact lens and by the area and intensity of staining on fluoresceinangiography. Treated patients were compared with a retrospectively matchedgroup of patients who were managed with observation only.

Main Outcome Measures  Changes in visual acuity and amount of macular edema were assessed inthe treated patients and compared with the observation group.

Results  The mean baseline visual acuity in the treatment group was 20/132 vs20/123 for the observation group (P = .57). After1 week, the treated group had a mean visual acuity of 20/51. At final follow-up,the treated group had a mean visual acuity of 20/37 while the observationgroup had a mean visual acuity of 20/110 (P = .001).Sixty percent of treated patients had a final visual acuity of 20/40 or bettervs only 20% in the observation group (P = .01). Fortypercent of the untreated patients had a final visual acuity worse than 20/200while none of the treated patients did (P<.001).At final follow-up, 75% of treated patients had complete resolution of macularedema on clinical examination vs only 20% of the untreated patients (P<.001). Two of the treated patients had recurrenceof macular edema at 6 months, and 3 had elevated intraocular pressure.

Conclusion  This study shows a treatment benefit from intravitreal triamcinolonein terms of visual acuity and macular edema for nonischemic CRVO.