Combination therapy of intravitreal bevacizumab with single simultaneous posterior subtenon triamcinolone acetonide for macular edema due to branch retinal vein occlusion

Abstract

Purpose To evaluate efficacy and safety of combination therapy of intravitreal bevacizumab (IVB) with single simultaneous posterior subtenon triamcinolone acetonide (STA) for treatment of macular edema (ME) secondary to branch retinal vein occlusion (BRVO). Methods This was a prospective, randomized, interventional comparative study conducted in 45 eyes with ME secondary to BRVO who were treated primarily with IVB 1.25 mg (23 eyes, IVB group) or combination therapy of IVB 1.25 mg with a single simultaneous STA 40 mg (18 eyes, IVB/STA group). Reinjections were performed with IVB if optical coherence tomography (OCT) showed recurrent ME associated with decreased visual acuity. The main outcome measurement was the number of additional IVB injections, and changes of best-corrected visual acuity (BCVA) and central macular thickness (CMT) during a 6-month follow-up period were compared. Results BCVA showed significant improvement in two groups at 6 months. In addition, CMT showed significant decrease in two groups at 6 months. No significant differences in the change of BCVA and CMT at 6 months after injection (P = 0.973, P = 0.639) were observed between the two groups. A statistically significant difference was found regarding the number of additional IVB injections (IVB group 0.96 ± 0.83; IVB/STA group 0.44 ± 0.70, P = 0.034).Conclusion Although combination therapy of IVB with a single simultaneous STA for treatment of ME secondary to BRVO did not affect the visual outcomes compared with IVB monotherapy, it had a benefit of reducing the number of additional IVB injections.

Effect of funding source on reporting bias in studies of intravitreal anti‐vascular endothelial growth factor therapy for retinal vein occlusion

“…; Moon et al. ; Li et al. ), statistically significant main outcome measures were reported in 29 of 38 (76%) high‐impact publications and in 4 of 7 (57%) of low‐impact publications (p = 0.43).…”

Implication of inflammatory cytokines in the aqueous humour for management of macular diseases

“…One study has demonstrated that combination therapy with both anti‐VEGF and anti‐inflammatory agents reduced the number of intravitreal anti‐VEGF needed to keep the disease under control (Moon et al. ). Therefore, anti‐inflammation may be a critical component of a combination therapy for RVO and DME.…”

Comparison between anti-VEGF therapy and corticosteroid or laser therapy for macular oedema secondary to retinal vein occlusion: A meta-analysis

“…Based on all of this evidence and the findings of the current meta‐analysis, we conclude that intravitreal anti‐VEGF agents are more effective than corticosteroid and laser therapy for improving BCVA and decreasing CRT in patients with macular oedema secondary to RVO. However, it should be noted that this may not be the case in all patients because triamcinolone and grid laser photocoagulation have both been shown to reduce the number of intravitreal anti‐VEGF injections required to maintain therapeutic results. In further support, Stefánsson theorized that laser coagulation reduces retinal tissue hypoxia and the subsequent production of VEGF.…”