The Effect Of One Single Intravitreal Triamcinolone Acetonide Injection In The Management Of Macular Edema Caused By Branch Retinal Vein Occlusion

Branch retinal vein occlusion(BRVO)is a common retinal vascular disease which can lead the development of macular edema(ME),and further decrease visual acuity.Until now,the most common therapy in dealing with ME included,macular grid laser photocoagulation,intravitreal injection of corticosteroids,such as triamcinolone acetonide(TA),or intravitreal injection of antivascular endothelial growth factor(anti-VEGF).However,differs in therapeutic advantage cause diversity of the cure schemes which fit for different individuals.Inravitreal injection of TA is one of the feasible methods.We need deeper invasive studies to objectively asset this effect.Our study includes two parts:(1)To evaluate the effect of one single intravitreal triamcinolone acetonide(IVTA)injection in the management of ME caused byBRVO.Try to figure out the predictable baseline factors correlated with the recovery of ME,and provide clues for reasonable individualtherapies.(2)To compare the retinal nerve fiber thickness(RNFL)after one dose IVTA or laser in the treatment of macular edema(ME)due to branch retinal vein occlusion(BRVO),further evaluate the prognosis of these methodsPart Ⅰ.Factors correlated with the resolution of macularedema after one dose intravitrealtriamcinolone acetonide treatment in branch retinal vein occlusionPurpose To evaluate the effect of one single IVTA in the management of MEcaused by BRVO.Try to find out the predictable baseline factors correlated with the recovery of ME.Methods The retrospective uncontrolled clinical study enrolled patients with ME(macular retinal thickness MRT≥300 μ m)due to BRVO who still had ME aftergrid laser photocoagulation.Patients were divided according to treatment into an IVTA group and a laser-only group.At month 3 and month 6 follow-up,the resolution of ME was documented.In IVTA group,the correlation between relevant baseline factors and the recovery of the ME was analyzed.Further the morphology of BRVO between the two subgroups was also assessed.Results A total of 154 eyes with ME were investigated:IVTA group(90 eyes)and laser-only group(64 eyes).In comparison of IVTA and laser onlygroup,significant reduction of macular retinal thickness(MRT),and the recovery numbers of ME combined withserous retinal detachment(SRD)were observed at month 3 and month 6.While,recurrence of ME was significantly different at month 3,but not at month 6.Predictive factors for successful IVTA treatment were younger age,shorter duration of ME,initial onset ME,accompanied by serous retinal detachment,few concomitant systemic diseases and nonischaemic BRVO.A broken foveal capillary ring was related to a poor treatment outcome.Eyes with cystoid spaces in the outer plexiform layer were more likely to have a good treatment response.Conclusion IVTA is effective for resolving ME due to BRVO after grid laser photocoagulation treatment,especially in the cases with SRD.ME patients caused by BRVO with younger age,initial onset,SRD,non-ischemic have a good response to one dose TA treatment.Part Ⅱ Comparison of retinal nerve fiber layer thickness after one dose intravitreal triamcinolone acetonide treatment or laser treatment of macular edema due to branch retinal vein occlusionObjective To compare the RNFL thickness after one dose IVTA treatment or laser treatment of ME due to BRVO.Methods This retrospective study enrolled patients with ME(macular retinal thickness MRT≥300 μm)due to BRVO who still had ME 3 months after grid laser photocoagulation.Patients were divided according to treatment into an IVTA group and a laser-only group.The thickness of RNFL was documented at months 3 and 6,and was compared between the two groups and fellow eyes,and also in resolute group,the thickness was compared between two groups and fellow eyes,and also in ischemic and nonischemic cases.Results A total of 152 eyes with ME were involved in this study,with 88 in IVTA group and 64 in laser-only group.At month 6 follow-up,75 cases had resolute ME,their RNFL thickness were statistically different from the fellow eyes.47 cases in IVTA group and 28 cases in laser-only group had resolute ME,their RNFL thickness were statistically different at month 6.The resolute ischemic cases were 30 at month 6 fellow-up,while resolute nonischemic cases were 45.Their RNFL thicknesses were statistically different at month 6,not at month 3.Conclusion One dose IVTA could prevent from inflicting RNFL of BRVO patients.