Early treatment of cystoid macular edema secondary to branch retinal vein occlusion with intravitreal triamcinolone acetonide.

BACKGROUND AND OBJECTIVE: To determine the efficacy of intravitreal triamcinolone acetonide (IVTA) in the early treatment of severe cystoid macular edema (CME) related to acute branch retinal vein occlusion.

PATIENTS AND METHODS: Retrospective, non-comparative case series. Twelve eyes with severe CME (foveal thickness > 450 microm) secondary to acute branch retinal vein occlusion received IVTA.

RESULTS: Average follow-up was 15.3 months. Mean visual acuity was 0.88 LogMar units (20/160) initially, 0.55 LogMar units (20/70) at 1 week, 0.46 LogMar units (20/60) at 1 month, and 0.49 LogMar units (20/60) at last follow-up. Visual acuity improved by 3 lines or greater in 42% of patients at 1 week, 50% at 1 month, and 42% at last follow-up. Average foveal thickness was 589 microm (range, 460 to 840 microm) at baseline, 237 microm at 1 week, 196 microm at 1 month, and 235 microm at last follow-up. All eyes showed reduction of foveal thickness as measured by optical coherence tomography. Eight eyes developed recurrent CME at an average of 5.5 months after initial IVTA injection. Ten eyes required additional intervention during the follow-up period.

CONCLUSIONS: Early treatment of severe CME secondary to branch retinal vein occlusion with IVTA is effective in reducing foveal thickness as measured by optical coherence tomography and improving visual acuity. However, monotherapy with IVTA can be associated with a significant rate of recurrent CME.