Efficacy of Intravitreal Triamcinolone Acetonide in the Treatment of Macular Oedema in Retinal Vein Occlusion Refractory to Anti-VEGF Therapy - A Prospective Interventional Study from a Tertiary Care Centre in Eastern India

Abstract

BACKGROUND Macular oedema due to retinal vein occlusion can be refractory to treatment with anti-vascular endothelial growth factor agents in some patients. We wanted to evaluate the efficacy of single dose of intravitreal triamcinolone acetonide in the treatment of macular oedema due to retinal vein occlusion, which is refractory to anti-vascular endothelial growth factor agents. METHODS 32 patients with refractory macular oedema were included in this prospective, interventional, comparative study. 20 patients were included in the study group and received 4 mg / 0.1 ml of intravitreal triamcinolone acetonide. 12 patients in control group did not receive any treatment. Best corrected visual acuity (BCVA) and central foveal thickness (CFT) were assessed in each group at 1 week, 1 month, 2 months and 3 months following injection. RESULTS Mean BCVA in study group improved from 1.36 ± 0.33 logarithm of minimum angle of resolution (LogMAR) at baseline to 0.94 ± 0.49 LogMAR at the end of 3 months. Mean CFT at baseline and 3 months was 498.65 ± 90.64 and 331 ± 100.57 microns respectively in the study group. The mean baseline BCVA and CFT in the control group was 1.19 ± 0.43 LogMAR and 428.33 ± 101.75 microns respectively. Mean BCVA and CFT at the end of 3 months was 1.16 ± 0.45 LogMAR and 424.75 ± 98.75 microns respectively. Change in mean BCVA and CFT at baseline and at the end of 3 months was found to be statistically significant (P = 0.000) between the 2 groups. There was increase in macular oedema in the study patients after the 2nd month following injection leading to slight worsening of visual acuity. CONCLUSIONS Intravitreal triamcinolone acetonide is an option in the treatment of macular oedema due to retinal vein occlusion refractory to anti-vascular endothelial growth factor agents. However, the efficacy of a single injection is short lived. Multiple injections might be needed to maintain the visual gains. KEYWORDS Retinal Vein Occlusion, Macular Oedema, Refractory, Triamcinolone, Intravitreal