Intravitreal triamcinolone acetonide vs bevacizumab for treatment of macular oedema due to central retinal vein occlusion

Purpose To compare the efficacy of intravitreal triamcinolone acetonide vs intravitreal bevacizumab in eyes with macular oedema caused by central retinal vein occlusion (CRVO). Design Retrospective consecutive case series. Methods Retrospective review of the medical records of 35 consecutive patients (35 eyes) with macular oedema associated with CRVO. Twenty-two patients were treated with intravitreal injection of 4 mg/0.1 ml triamcinolone acetonide. The other 13 patients accepted intravitreal bevacizumab 1.25 mg in 0.05 ml. Initial visual acuity, intraocular pressure (IOP), and macular thickness were recorded. Final visual acuity, IOP, macular thickness, and adverse events were recorded during the treatment period. Results The mean follow-up was 282.73 +/- 70.62 days in the group administered with triamcinolone acetonide and 253.92 +/- 36.10 days in the study group who accepted bevacizumab, respectively. Visual acuity measurements improved significantly and showed significant macular oedema resolution in optical coherence tomography examination in both the two groups. However, the therapeutic effects had no significant difference between these two groups with regard to visual results (F = 1.723, P = 0.240) and macular thickness decrease (F = 1.814, P = 0.832). Thirteen eyes developed recurrent macular oedema and received repeat injections of triamcinolone acetonide or bevacizumab. Conclusion Intravitreal injection of triamcinolone acetonide or bevacizumab can both lead to a significant improvement in visual acuity and a resolution of macular oedema in patients with CRVO. However, the significant effect was not permanent. Besides, the efficacy of intravitreal triamcinolone acetonide showed no significant differences compared with intravitreal bevacizumab but seemed to cause more adverse events than bevacizumab. Eye (2009) 23, 2215-2222; doi:10.1038/eye.2008.429; published online 13 February 2009