Posterior subtenon triamcinolone, intravitreal triamcinolone and grid laser photocoagulation for the treatment of macular edema in branch retinal vein occlusion

PURPOSE: To evaluate the efficacy of posterior subtenon triamcinolone (PSTT), intravitreal triamcinolone (IVT) injections and grid laser photocoagulation (GLP) in eyes with macular edema secondary to branch retinal vein occlusion (BRVO).

MATERIAL AND METHODS: Patients with macular edema due to BRVO treated with PSTT, IVT injections or GLP were evaluated retrospectively. Complete ophthalmic examination with fluorescein angiography and optic coherence tomography were noted before and in the 1st, 3rd, and 6th months of the treatment. The visual and anatomical responses were evaluated and compared between the groups using paired t test and one-way ANOVA test.

RESULTS: There were 20, 35 and 24 eyes in the PSTT, IVT and GLP groups. In the PSTT group, the mean visual acuity (VA) and central foveal thickness (CFT) were 0.23 +/- 0.23 and 413.2 +/- 143.5 microm before treatment and 0.23 +/- 0.18 and 358.7 +/- 109.2 microm at the 3rd month, respectively (p = 0.504 and p = 0.031). The mean VA increased from 0.14 +/- 0.15 to 0.33 +/- 0.26 and the mean CFT decreased from 518.2 +/- 145 to 292.9 +/- 121 microm in IVT group at the 3rd month (p = 0.001). The mean VA increased from 0.29 +/- 0.25 to 0.47 +/- 0.32 (p = 0.001); CFT decreased from 397.3 +/- 105.9 to 307.1 +/- 88.4 microm (p = 0.005) in the GLP group. VA and CFT changes were significantly different between the groups at the 3rd month (p = 0.031). VA increase was significantly greater in the IVT group than in the PSTT group. Decrease in CFT was the highest in the IVT group (Tukey, p = 0.001).

CONCLUSIONS: IVT and GLP seemed to be more effective than PSTT for the treatment of BRVO-associated macular edema. Possible complications of IVT and GLP must be weighted with the advantages of each treatment modality for each patient.