J Korean Ophthalmol Soc > Volume 59(9); 2018 > Article
Journal of the Korean Ophthalmological Society 2018;59(9):834-841.
DOI: https://doi.org/10.3341/jkos.2018.59.9.834    Published online September 15, 2018.
A Comparison of Three Intravitreal Modalities of Branch Retinal Vein Occlusion Macular Edema.
Han Song, Hee Jun Song, Ji Ho Yang, Do Gyun Kim
Department of Ophthalmology, Myongji Hospital, Goyang, Korea. Kimdk89@empas.com
망막분지정맥폐쇄 황반부종에서 세 가지 유리체강 내 약물주입술의 단기 효과 비교
송 한⋅송희준⋅양지호⋅김도균
명지병원 안과
Correspondence:  Do Gyun Kim,
Email: Kimdk89@empas.com
Received: 17 May 2018   • Revised: 23 June 2018   • Accepted: 28 August 2018
Abstract
PURPOSE
Short-term results regarding the efficacy of intravitreal bevacizumab, dexamethasone implants, and triamcinolone-bevacizumab in macular edema (ME) secondary to branch retinal vein occlusion (BRVO) were compared. METHODS: This study included 30 eyes of with BRVO and ME. Patients received the following treatments: 1.25 mg of bevacizumab (group 1, n = 9), 0.7 mg of dexamethasone as an implant (group 2, n = 12), or a combination of 2 mg of triamcinolone acetonide and 1.25 mg of bevacizumab (group 3, n = 9). Measurements of visual acuity and central macular thickness (CMT) with optical coherence tomography were performed at baseline, and at 1 and 3 months injection. RESULTS: Compared to baseline, the CMT was significantly decreased in all groups by 326.32 ± 149.32, 311.50 ± 58.54, and 282 ± 28.21, respectively, at 1 month and 407 ± 160, 348 ± 108, and 289 ± 66, respectively, at 3 months, but there was no significant difference within each group. Compared to baseline, best-corrected visual acuity (BCVA) was significantly increased in all groups at 1 month and 3 months. Using post hoc analysis, there was no significant difference in the degrees of BCVA gain, but in degrees of CMT reduction, groups 2 and 3 were significantly higher than group 1 at 1 month and only group 3 was significantly higher than group 1 at 3 months (p < 0.017). CONCLUSIONS: The intravitreal injection of bevacizumab, a dexamethasone implant, or a combination of triamcinolone-bevacizumab could be effectively used in the treatment of ME due to BRVO. For ME, steroid treatment showed a greater reduction percentage, and in the case of the triamcinolone-bevacizumab combination, we could cover the short half-life of bevacizumab and the complications of steroid use. In severe cases of ME, an intravitreal dexamethasone implant or a combination of triamcinolone and bevacizumab can be considered as the first-line therapy.
Key Words: Bevacizumab;Branch retinal vein occlusion;Dexamethasone implant;Triamcinolone


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