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Trans-Tenon's Retrobulbar Triamcinolone Acetonide Injection for Macular Edema related to Branch Retinal Vein Occlusion
  1. Takahiro Kawaji (kawag{at}white.plala.or.jp),
  2. Akiomi Takano,
  3. Yasuya Inomata,
  4. Nina Sagara,
  5. Keiichiro Iwao,
  6. Masaru Inatani,
  7. Mikiko Fukushima,
  8. Hidenobu Tanihara
  1. Kumamoto University Gratuate School of Medical Sciences, Japan
  2. Kumamoto University Gratuate School of Medical Sciences, Japan
  3. Kumamoto University Gratuate School of Medical Sciences, Japan
  4. Kumamoto University Gratuate School of Medical Sciences, Japan
  5. Kumamoto University Gratuate School of Medical Sciences, Japan
  6. Kumamoto University Gratuate School of Medical Sciences, Japan
  7. Kumamoto University Gratuate School of Medical Sciences, Japan
  8. Kumamoto University Gratuate School of Medical Sciences, Japan

    Abstract

    Background: To evaluate the safety and effectiveness of trans-Tenon’s retrobulbar triamcinolone acetonide (TA) injection for macular edema associated with branch retinal vein occlusion (BRVO).

    Methods: We reviewed the medical records of 50 consecutive patients with macular edema associated with BRVO who were treated with trans-Tenon’s retrobulbar TA injection (20 mg) as initial treatment for at least 12 months follow-up period. Foveal thickness determined by optical coherence tomography, visual acuity, intraocular pressure (IOP) and cataract progression were measured.

    Results: The mean duration between edema onset and TA injection was 4.9 months. Foveal thickness decreased significantly at 3 months after injection (P <.0001). Furthermore, percent reduction in foveal thickness in eyes with posterior vitreous detachment (PVD, n = 23) was significantly greater than that without PVD (n = 27, P = .003). Improved visual acuity by at least 0.20 logMAR was seen in 22 eyes (44%; 11 eyes with PVD and 11eyes without PVD). After completion of the 3-month follow-up, 29 eyes (58%) needed additional treatment including TA injections or pars plana vitrectomy (PPV). PPV seemed to be effective for macular edema resistant to TA. IOP elevation and cataract progression occurred in less than 10% of all patients.

    Conclusions: Trans-Tenon’s retrobulbar TA injection appeared safe and relatively effective for macular edema associated with BRVO. In eyes resistant to TA injection, PPV may be effective as an adjunctive treatment.

    • branch retinal vein occlusion
    • macular edema
    • trans-Tenon's retrobulbar injection
    • triamcinolone

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