J Korean Ophthalmol Soc > Volume 59(8); 2018 > Article
Journal of the Korean Ophthalmological Society 2018;59(8):730-737.
DOI: https://doi.org/10.3341/jkos.2018.59.8.730    Published online August 15, 2018.
Effectiveness of Intravitreal Preservative-free Triamcinolone Injection for Refractory Macular Edema Secondary to Retinal Vein Occlusion.
Chang Hwan Lee, Moo Hwan Jang, Young Seung Seo
Department of Ophthalmology, Dankook University Hospital, Dankook University College of Medicine, Cheonan, Korea. mailcarr@naver.com
망막정맥폐쇄에서 베바시주맙에 불응성인 황반부종에 대한 무보존제 트리암시놀론주입술의 효과
이창환⋅장무환⋅서영승
단국대학교 의과대학 단국대학교병원 안과학교실
Correspondence:  Young Seung Seo,
Email: mailcarr@naver.com
Received: 29 March 2018   • Revised: 17 May 2018   • Accepted: 19 July 2018
Abstract
PURPOSE
To evaluate the efficacy of intravitreal preservative-free triamcinolone acetonide (Maqaid®) injection for the treatment of macular edema secondary to retinal vein occlusion (RVO) refractory to intravitreal bevacizumab injections. METHODS: This retrospective, observational study included 17 eyes of 17 patients with refractory macular edema secondary to RVO. The patients with macular edema unresponsive to intravitreal bevacizumab injections were treated with intravitreal preservative-free triamcinolone acetonide (Maqaid®) injection. Best-corrected visual acuity (BCVA) and central foveal thickness (CFT) based on optical coherence tomography were evaluated before intravitreal triamcinolone injection (IVTA), 1 month and 3 months after IVTA injection. intraocular pressure (IOP) changes were analyzed up to 6 months. RESULTS: The logarithm of the minimal angle of resolution (logMAR) BCVA was decreased from 0.56 ± 0.32 to 0.41 ± 0.32 after 1 month with statistical significance (p = 0.006) and to 0.47 ± 0.36 after 3 months of IVTA without statistical significance (p = 0.204). CFT was significantly improved from 474.82 ± 91.91 µm to 262.58 ± 60.11 µm after 1 month and to 339.58 ± 152.48 µm after 3 months of IVTA injection (p ≤ 0.001 and 0.005, respectively). IOP was significantly increased from 13.11 ± 2.66 mmHg to 16.64 ± 5.66 mmHg after 1 month and to 17.05 ± 7.21 µm after 3 months of IVTA injection (p = 0.024 and 0.026, respectively). Treatment-associated IOP elevation was manageable with antiglaucoma medications. IOP was 15.13 ± 3.90 mmHg after 6 months of IVTA injection (p = 0.023). CONCLUSIONS: Intravitreal preservative-free triamcinolone (Maqaid®) Injection improves BCVA and reduces CFT in some patients with macular edema secondary to RVO refractory to intravitreal bevacizumab therapy. There were no serious vision-threatening complications associated with intravitreal preservative-free triamcinolone (Maqaid®) therapy during the study period. Intravitreal preservative-free triamcinolone (Maqaid®) could be considered as a treatment option for refractory macular edema associated with RVO.
Key Words: Intraocular pressure;Intravitreal injection;Macular edema;Preservative-free triamcinolone;Retinal vein occlusion


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