Intravitreal bevacizumab vs triamcinolone acetonide for macular oedema due to central retinal vein occlusion.

PURPOSE: To compare the effect of intravitreal bevacizumab vs intravitreal triamcinolone for the treatment of non-ischaemic central retinal vein occlusion (CRVO).

METHODS: The comparative nonrandomized retrospective clinical interventional study included 72 patients with non-ischaemic CRVO, divided into a bevacizumab group of 30 patients (1.25 mg bevacizumab) and a triamcinolone group of 42 patients (4.0 mg triamcinolone). All patients were consecutively included. At baseline, both study groups did not vary significantly in visual acuity, macular thickness, and duration of symptoms (191+/-300 days vs 222+/-256 days). The minimal follow-up was 3 months (mean: 7.8+/-4.3 months; range: 3-12 months). During follow-up, 1.3+/-0.4 re-injections of the triamcinolone group (range:1-2 injections) and 2.7+/-1.8 re-injections of bevacizumab (range:1-6 injections) were administered.

RESULTS: In both study groups, the mean visual acuity increased significantly (P<0.001) from baseline during follow-up. The differences in gain in visual acuity were not statistically significant (P>0.40) between both study groups at any time during follow-up. The mean macular thickness decreased significantly (P<0.001) in both study groups, with the reduction being significantly (P=0.006) more pronounced in the triamcinolone group. Intraocular pressure increased significantly (P<0.001) in the triamcinolone group.

CONCLUSIONS: In long-standing non-ischaemic CRVO, intravitreal bevacizumab and intravitreal triamcinolone are both associated with a comparable gain in visual acuity. The reduction in macular oedema was more marked in the triamcinolone group. In view of the potential complications of intravitreal triamcinolone in terms of intraocular pressure rise and cataractogenesis, bevacizumab may be preferred compared with triamcinolone for intravitreal use in non-ischaemic CRVO.