PHARMACOLOGICAL INTRAVITREAL TREATMENT FOR MACULAR EDEMA IN BRANCH RETINAL VEIN OCCLUSION - THREE-MONTH RESULTS

Macular edema is the main cause of visual loss in patients with branch retinal vein occlusion. Macular edema is initially reversible, but over time, permanent loss ofvision occurs from structural damage to the macula. For this reason, there is a need for more rapid and effective treatments than laser photocoagulation which has been established as a gold standard. There are several pharmacologic agents which have changed the management of macular edema.

Twenty eyes of 20 consecutive patients of the Department of Eye Diseases, Clinical Center of Vojvodina, in Novi Sad, were enrolled in this prospective, randomized and consecutive study conducted from January 2012 to January 2013. The patients were randomly assigned into two treatment groups, and they were given an intravitreal injection of bevacizumab 1.25 mg/0.05 mL (Avastin®), or triamcinolone acetonid injection 4 mg/0.1 mL (Kenalog®). Reinjections were performed according to the following retreatment criteria a loss of visual acuity or increase in central retinal thickness.

Both intravitreal bevacizumab and triamcinolon-acetonid were very effective in reducing macular edema and improving visual acuity in the eyes with macular edema secondary to retinal vein occlusion. The effect of the treatment was more pronounced if it started early after the onset of macular edema. The reported temporary effects of intravitreal triamcinolon-acetonide and bevacizumab could be explained by their clearance from the eye.

The short-term results of our clinical trial showed that pharmacological intravitreal agents, such as bevacizumab and triameinolon-acetonid, lead to rapid resolution of macular edema and significant improvement of visual acuity.