COMPARISON OF INTRAVITREAL BEVACIZUMAB AND TRIAMCINOLONE ACETONIDE WITH INTRAVITREAL BEVACIZUMAB ALONE IN MACULAR EDEMA SECONDARY TO CENTRAL RETINAL VEIN OCCLUSION

Main Article Content

Usman Attique
Yousaf Jamal Mahsood
Sanaullah Jan

Abstract

OBJECTIVES: To compare the effect of intravitreal-bevacizumab (IVB) and intravitreal-triamcinolone (IVT) with IVB alone on visual acuity (VA) and central foveal thickness (CFT) in patients with macular edema (ME) secondary to central retinal vein occlusion (CRVO).


METHODS: This quasi-experimental study was conducted from June 2018 to December 2018 on patients with ME secondary to CRVO, admitted at Hayatabad Medical Complex, Peshawar, Pakistan. Out of thirty patients included in this study, fifteen were included in Group-A (received combination therapy IVT and IVB) and 15 in Group-B (received IVB alone). The subjects were followed up at 3rd and 6th month post-treatment and changes in VA (logMAR) and CFT were recorded at each visit. The comparative analyses of variables were carried out with-in the groups and between the groups.


RESULTS: Mean age of patients was 60.93±4.38 years (group-A) and 60.73±3.67 years (group-B). Mean VA at baseline & 6th month was 0.87±0.09 & 0.32±0.06 in group-A as compared to 0.88±0.10 to 0.44±0.06 LogMAR units in group-B respectively (p<0.001). Mean CFT at baseline & 6th month was 673.67±38.33 & 264.4±16.73 in group-A as compared to 674.07±36.32 & 271.01±20.14 μm in group-B respectively (p<0.001). There was no significant difference in CFT between the two groups at 3rd month (p=0.84) and 6th month (p<0.33) post-treatment, although it was statistically significant when compared within the groups. 


CONCLUSION: Combined treatment is more effective than IVB alone in improving VA in CRVO related ME. However, the effect of combined treatment on CVT is not superior to IVB alone.

Article Details

How to Cite
Attique, Usman, et al. “COMPARISON OF INTRAVITREAL BEVACIZUMAB AND TRIAMCINOLONE ACETONIDE WITH INTRAVITREAL BEVACIZUMAB ALONE IN MACULAR EDEMA SECONDARY TO CENTRAL RETINAL VEIN OCCLUSION”. KHYBER MEDICAL UNIVERSITY JOURNAL, vol. 13, no. 1, Mar. 2021, pp. 15-9, doi:10.35845/kmuj.2021.21087.
Section
Original Articles

References

Fuller JJ. Retinal Vein Occlusions: Update on Diagnostic and Therapeutic Advances. Focal Points 2007.

Pichi F, Hsu J, Lim JI, Tripathy K, Gill MK, Shah VA. Central Retinal Vein Occlusion. EyeWiki 2019. [Accessed on: December 05, 2020]. Available from URL: https://eyewiki.aao.org/Central_Retinal_Vein_Occlusion

Gregori NZ. What Is Central Retinal Vein Occlusion (CRVO)? American Academy of Ophthalmology. [Accessed on: December 05, 2020]. Available from URL: https://www.aao.org/eye-health/diseases/what-is-central-retinal-vein-occlusion.

Kooragayal LM. Central Retinal Vein Occlusion (CRVO). Medscape 2019 [Accessed on: December 05, 2020]. Available from URL: https://emedicine.medscape.com/article/1223746-overview

Yoshizawa C, Saito W, Kase M, Ishida S. Clinical features of central retinal vein occlusion with inflammatory etiology. Asia Pac J Ophthalmol (Phila) 2012 Sep 1;1(5):270-6. DOI: 10.1097/APO.0b013e318266de04.

Lazić R, Boras I, Vlasić M, Gabrić N, Tomic Z. Anti-VEGF in treatment of central retinal vein occlusion. Coll Antropol 2010 Apr 34:Suppl 2:69-72.

Rhoades W, Dickson D, Nguyen QD, Do DV. Management of macular edema due to central retinal vein occlusion–the role of aflibercept. Taiwan J Ophthalmol 2017 Apr;7(2):70-6. DOI: 10.4103/tjo.tjo_9_17.

Mehta H, Hennings C, Gillies MC, Nguyen V, Campain A, Fraser‐Bell S. Anti‐vascular endothelial growth factor combined with intravitreal steroids for diabetic macular oedema. Cochrane Database Sys Rev 2018 April 18;4(4):CD011599. DOI: 10.1002/14651858.CD011599.pub2.

Feldman B, Lim J, Tripathy K, Kim L, Karth P, Shah V. Bevacizumab. EyeWiki 2019. [Accessed on: December 05, 2020]. Available from URL: https://eyewiki.aao.org/Bevacizumab

Demir M, Dirim B, Acar Z, Sendul Y, Oba E. Comparison of the effects of intravitreal bevacizumab and triamcinolone acetonide in the treatment of macular edema secondary to central retinal vein occlusion. Indian J Ophthalmol 2014 Mar;62(3):279-83. DOI: 10.4103/0301-4738.105769.

Mayer WJ, Wolf A, Kernt M, Kook D, Kampik A, Ulbig M, et al. Twelve-month experience with Ozurdex for the treatment of macular edema associated with retinal vein occlusion. Eye 2013 Jul;27(7):816-22. DOI: 10.1038/eye.2013.79.

The Royal college of Ophthalmologist. Retinal Vein Occlusion (RVO) Guidelines, 18 Stephenson Way, London. The Royal college of Ophthalmologist. [Accessed on: December 05, 2020]. Available from URL: https://www.rcophth.ac.uk/wp-content/uploads/2015/07/Retinal-Vein-Occlusion-RVO-Guidelines-July-2015

Brown DM, Campochiaro PA, Singh RP, Z Li, S Gray, Saroj N, et al. Ranibizumab for macular edema following central retinal vein occlusion: six-month primary end point results of a phase III study. Ophthalmology 2010 Jun;117(6):1124-33. DOI: 10.1016/j.ophtha.2010.02.022.

Garweg G. Justus, Zandi S. Retinal vein occlusion and the use of a dexamethasone intravitreal implant (Ozurdex®) in its treatment. Graefes Arch Clin Exp Ophthalmol 2016;254:1257–x65. DOI: 10.1007/s00417-016-3350-x.

Ali IR, Kapoor GK, Khan NA, Gibran KS. Efficacy of combined intravitreal bevacizumab and triamcinolone for branch retinal vein occlusion. Indian J Ophthalmol 2014 Apr;62(4):396-9. DOI: 10.4103/0301-4738.120227.

Brown DM, Campochiaro PA, Singh RP, Li Z, Gray S, Saroj N, et al. Ranibizumab for macular edema following central retinal vein occlusion: Six-month primary end point results of a phase III study. Ophthalmology 2010; 117:1124–33.e1.

Kooragayala ML. Central Retinal Vein Occlusion (CRVO). [Internet]. New York: Medscape; [Accessed on: December 05, 2020]. Available from URL: https://emedicine.medscape.com/article/1223746-treatment#d5.

Chiquet C, Dupuy C, Bron AM, Aptel F, Straub M, Isacio R, et al. Intravitreal dexamethasone implant versus anti-VEGF injection for treatment-naïve patients with retinal vein occlusion and macular edema: a 12-month follow-up study. Graefes Arch Clin Exp Ophthalmol 2015 Dec;253(12):2095-102. DOI: 10.1007/s00417-015-2947-9.

Haller JA, Bandello F, Belfort Jr R, Blumenkranz MS, Gillies M, Heier J, et al. Dexamethasone intravitreal implant in patients with macular edema related to branch or central retinal vein occlusion twelve-month study results. Ophthalmology 2011;118(12):2453-60. DOI: 10.1016/j.ophtha.2011.05.014.

Sharareh B, Gallemore R, Taban M, Onishi S, Wallsh J. Recalcitrant macular edema after intravitreal bevacizumab is responsive to an intravitreal dexamethasone implant in retinal vein occlusion. Retina 2013 Jun 1;33(6):1227-31. DOI: 10.1097/IAE.0b013e31827c53a0.

Ozkok A, Saleh OA, Sigford DK, Heroman JW, Schaal S. THE OMAR STUDY: comparison of ozurdex and triamcinolone acetonide for refractory cystoid macular edema in retinal vein occlusion. Retina 2015 Jul 1;35(7):1393-400. DOI: 10.1097/IAE.0000000000000475.

Campochiaro PA, Wykoff CC, Brown DM, Boyer DS, Barakat M, Taraborelli D, et al. Suprachoroidal triamcinolone acetonide for retinal vein occlusion: results of the Tanzanite Study. Ophthalmol Retina 2018 Apr 1;2(4):320-8. DOI: 10.1016/j.oret.2017.07.013.

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