Intravitreal Vs Posterior Sub-Tenon Triamcinolone Acetonide Injection For The Treatment Of Retinal Vein Occlusion

ObjectiveTo evaluate the efficacy of intravitreal triamcinolone acetonide (IVTA) and posterior sub-tenon triamcinolone acetonide (PSTT) for treatment of macular edema (ME) secondary to retinal vein occlusion (RVO).ParticipantsMale (30)/Female (17)MethodsFifty-one eyes of47patients with macular edema due to retinal vein occlusion (including central retinal vein occlusion and branch retinal vein occlusion) were randomly allocated into either IVTA(26eyes of23patients,14males and9females, mean age:48.2±16.2years) or PSTT (25eyes of24patients,16males and8females, mean age:52.4±10.6years). The main outcome measures included best-corrected visual acuity (BCVA), intraocular pressure (IOP) and central foveal thickness (CFT)5days,1month and3months before and after the initial injection.ResultsIn the IVTA group, the BCVA was0.1708±0.1769(standard visual acuity chart, mean±SD) at baseline and improved to0.3358±0.28635days post operation,0.3959±0.3462after1month,0.3644±0.3029after3months. The mean CFT was745±294μm (mean±SD) at baseline and it decreased to532±225μm5day post operation,351±165μm after1month,322±186μm after3months. In the PSTT group, the BCVA was0.1840±0.1753(standard visual acuity chart, mean±SD) at baseline and improved to0.3336±0.2168after5days,0.3842±0.2566after1month, and0.3533±0.2031after3months. The mean CFT was721±199μm (mean±SD) at baseline and it decreased to529±268μm after5days,379±225μm after1month,326±170μm after3months. The BCVA improvement was statistically significance (p<0.05) compared with baseline in both groups at every follow-up visit. The mean CFT is significant decreased (p<0.05) compared with baseline in both groups at all follow-up visits. The BCVA improvement and the mean CFT reduction were no statistically significant differences at every follow-up visit between the2groups (all p>0.05). In contrast to the PSTT group1out of25eyes (4%) has intraocular pressure>21mmHg post operation,4of26eyes (15%) has intraocular pressure>21mmHg in IVTA group, no other severe side effects are observed.ConclusionsPSTT treatment seems to achieve comparable outcomes with IVTA treatment in the improvement of BCVA and the reduction of CFT in retinal vein occlusion patients. While PSTT treatment has less complication in the term of elevation of intraocular pressure. PSTT injection could be an alternative therapy for the treatment of macular edema caused by retinal vein occlusion. A larger scale and long term observation of two therapies would further provide useful information in the treatment of macular edema caused by retinal vein occlusion.