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Comparison between intravitreal bevacizumab and posterior sub-tenon injection of triamcinolone acetonide in macular edema secondary to retinal vein occlusion.
Clin Ophthalmol 2018; 12:1229-1235CO

Abstract

Aim

To compare the efficacy and safety between posterior sub-tenon injection of triamcinolone acetonide (PSTA) and intravitreal injection of bevacizumab (Avastin) (IVIA) in the treatment of macular edema secondary to retinal vein occlusion.

Patients and methods

A total of 45 eyes were retrospectively enrolled (23 eyes with intravitreal bevacizumab and 22 eyes with posterior sub-tenon triamcinolone acetonide). Main endpoints included logMAR of best-corrected visual acuity (BCVA), central macular thickness (CMT), and intraocular pressure (IOP) before and after treatment at 6 months.

Results

The mean logMAR improved from 0.78 to 0.56 at 6 months for intravitreal bevacizumab (p=0.001), and from 0.91 to 0.79 and 0.87 at 3 and 6 months (p=0.038 and 0.13), respectively, for sub-tenon triamcinolone acetonide. At 6 months, the BCVA was significantly better in the bevacizumab group (p=0.02). Both groups' mean CMT significantly improved, from 478 µm at baseline to 295 µm at 6 months in IVIA group (p<0.001) and from 419 µm at baseline to 350 µm in PSTA group (p=0.012); however, this was not different between the groups at 6 months (p=0.065). Recurrence of macular edema was not different between the groups either (p=0.08). Poorer final vision was associated with poorer baseline BCVA and diagnosis of central retinal vein occlusion after adjustment for age and sex (p<0.001 and 0.012, respectively). Significant elevation of IOP was noted at 3 months in the PSTA group, but declined at 6 months compared with baseline (p=0.002 and 0.41, respectively).

Conclusion

Intravitreal bevacizumab seemed to achieve better visual acuity compared with posterior sub-tenon injections of triamcinolone acetonide at 6 months, while CMT was comparable. PSTA still resulted in transient IOP elevation.

Authors+Show Affiliations

Department of Ophthalmology, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei, Taiwan, yjpeng225@gmail.com.Department of Ophthalmology, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei, Taiwan, yjpeng225@gmail.com. Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan.Department of Ophthalmology, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei, Taiwan, yjpeng225@gmail.com.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

30013316

Citation

Tsai, Meng-Ju, et al. "Comparison Between Intravitreal Bevacizumab and Posterior Sub-tenon Injection of Triamcinolone Acetonide in Macular Edema Secondary to Retinal Vein Occlusion." Clinical Ophthalmology (Auckland, N.Z.), vol. 12, 2018, pp. 1229-1235.
Tsai MJ, Hsieh YT, Peng YJ. Comparison between intravitreal bevacizumab and posterior sub-tenon injection of triamcinolone acetonide in macular edema secondary to retinal vein occlusion. Clin Ophthalmol. 2018;12:1229-1235.
Tsai, M. J., Hsieh, Y. T., & Peng, Y. J. (2018). Comparison between intravitreal bevacizumab and posterior sub-tenon injection of triamcinolone acetonide in macular edema secondary to retinal vein occlusion. Clinical Ophthalmology (Auckland, N.Z.), 12, pp. 1229-1235. doi:10.2147/OPTH.S170562.
Tsai MJ, Hsieh YT, Peng YJ. Comparison Between Intravitreal Bevacizumab and Posterior Sub-tenon Injection of Triamcinolone Acetonide in Macular Edema Secondary to Retinal Vein Occlusion. Clin Ophthalmol. 2018;12:1229-1235. PubMed PMID: 30013316.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparison between intravitreal bevacizumab and posterior sub-tenon injection of triamcinolone acetonide in macular edema secondary to retinal vein occlusion. AU - Tsai,Meng-Ju, AU - Hsieh,Yi-Ting, AU - Peng,Yi-Jie, Y1 - 2018/07/06/ PY - 2018/7/18/entrez PY - 2018/7/18/pubmed PY - 2018/7/18/medline KW - bevacizumab KW - macular edema KW - retinal vein occlusion KW - sub-tenon injections KW - triamcinolone acetonide SP - 1229 EP - 1235 JF - Clinical ophthalmology (Auckland, N.Z.) JO - Clin Ophthalmol VL - 12 N2 - Aim: To compare the efficacy and safety between posterior sub-tenon injection of triamcinolone acetonide (PSTA) and intravitreal injection of bevacizumab (Avastin) (IVIA) in the treatment of macular edema secondary to retinal vein occlusion. Patients and methods: A total of 45 eyes were retrospectively enrolled (23 eyes with intravitreal bevacizumab and 22 eyes with posterior sub-tenon triamcinolone acetonide). Main endpoints included logMAR of best-corrected visual acuity (BCVA), central macular thickness (CMT), and intraocular pressure (IOP) before and after treatment at 6 months. Results: The mean logMAR improved from 0.78 to 0.56 at 6 months for intravitreal bevacizumab (p=0.001), and from 0.91 to 0.79 and 0.87 at 3 and 6 months (p=0.038 and 0.13), respectively, for sub-tenon triamcinolone acetonide. At 6 months, the BCVA was significantly better in the bevacizumab group (p=0.02). Both groups' mean CMT significantly improved, from 478 µm at baseline to 295 µm at 6 months in IVIA group (p<0.001) and from 419 µm at baseline to 350 µm in PSTA group (p=0.012); however, this was not different between the groups at 6 months (p=0.065). Recurrence of macular edema was not different between the groups either (p=0.08). Poorer final vision was associated with poorer baseline BCVA and diagnosis of central retinal vein occlusion after adjustment for age and sex (p<0.001 and 0.012, respectively). Significant elevation of IOP was noted at 3 months in the PSTA group, but declined at 6 months compared with baseline (p=0.002 and 0.41, respectively). Conclusion: Intravitreal bevacizumab seemed to achieve better visual acuity compared with posterior sub-tenon injections of triamcinolone acetonide at 6 months, while CMT was comparable. PSTA still resulted in transient IOP elevation. SN - 1177-5467 UR - https://www.unboundmedicine.com/medline/citation/30013316/Comparison_between_intravitreal_bevacizumab_and_posterior_sub_tenon_injection_of_triamcinolone_acetonide_in_macular_edema_secondary_to_retinal_vein_occlusion_ L2 - https://dx.doi.org/10.2147/OPTH.S170562 DB - PRIME DP - Unbound Medicine ER -