Intravitreal Veru Retrobulbar Injection of Triamcinolone for Macular Edema Aociated With Branch Retinal Vein Occluion

Purpoe To compare the hort-term effect of intravitreal veru retrobulbar injection of triamcinolone acetonide for the treatment of macular edema caued by branch retinal vein occluion. Deign Randomized clinical trial. Method ixty eye of 60 patient who had macular edema aociated with branch retinal vein occluion were randomly aigned to receive a ingle intravitreal injection (4 mg) or repeated retrobulbar injection (40 mg, three time) of triamcinolone. Thee injection (firt injection in the retrobulbar group) were given approximately 1 week after focal laer photocoagulation. Uing optical coherence tomography, the central retinal (foveal) thickne and total macular volume were meaured before and at 1 and 3 month after injection. Viual acuity, intraocular preure, and the incidence of reinjection were alo examined. Fifty-two patient (86.7%) completed the 3-month follow-up. Reult The mean foveal thickne and total macular volume decreaed ignificantly after either intravitreal or repeated retrobulbar triamcinolone injection. Foveal thickne and macular volume were ignificantly le after intravitreal injection than after repeated retrobulbar injection, although there had been no ignificant difference at baeline. The percent reduction in foveal thickne and macular volume were alo greater after intravitreal injection than after retrobulbar injection. Improvement in viual acuity wa ignificantly better after intravitreal injection than after the retrobulbar injection. The incidence of intraocular preure rie (to ≥20 mm Hg) wa greater in the intravitreal group than in the retrobulbar group, but thi wa readily controlled by the ue of antiglaucoma medication. After completion of the 3-month follow-up, 24 patient (46.2%) underwent reinjection. The need for reinjection wa ignificantly greater in the retrobulbar group than in the intravitreal group (P = .0001). Concluion A ingle intravitreal injection of triamcinolone i ignificantly more effective than are repeated retrobulbar injection in reducing macular edema aociated with branch retinal vein occluion, and lead to greater improvement in viual acuity.