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Randomized Controlled Trial
. 2020 Dec;59(4):569-575.
doi: 10.20471/acc.2020.59.04.01.

COMBINED TREATMENT WITH BEVACIZUMAB AND TRIAMCINOLONE ACETONIDE FOR MACULAR EDEMA DUE TO RETINAL VEIN OCCLUSION

Maja Vinković  1 , Damir Bosnar  1 , Eugenia Tedeschi Reiner  1 , Gabriella De Salvo  1 , Suzana Matić  1
Affiliations
Randomized Controlled Trial

COMBINED TREATMENT WITH BEVACIZUMAB AND TRIAMCINOLONE ACETONIDE FOR MACULAR EDEMA DUE TO RETINAL VEIN OCCLUSION

Maja Vinković et al. Acta Clin Croat. 2020 Dec.

Abstract

The purpose of this study was to determine the efficacy of combined intravitreal bevacizumab and triamcinolone in the treatment of macular edema due to retinal vein occlusion. A prospective randomized trial was conducted in the Department of Ophthalmology, Osijek University Hospital Centre in Osijek including 51 patients divided into three groups depending on the drug received. The first group received 1.25 mg intravitreal bevacizumab, the second group received 1 mg intravitreal triamcinolone, and the third group received a combination of 1.25 mg bevacizumab and 1 mg intravitreal triamcinolone on the same day. Changes in the central macular thickness, intraocular pressure and visual acuity were monitored during the follow up period. The retinal perfusion status was evaluated by fluorescein angiography. The group that received combined treatment had better outcome in terms of reduction of macular thickness. There was no statistically significant intraocular pressure elevation among the three treatment groups or within each group of patients. A positive trend regarding visual improvement was observed in the group receiving combined treatment in spite of the lowest initial visual acuity, highest value of macular thickness and longest mean duration of symptoms. In conclusion, combined treatment with bevacizumab and triamcinolone for the treatment of retinal vein occlusion is more potent, safe, efficient and cost-effective. It can also be recommended because fewer injections are needed in patients undergoing treatment for macular edema.

Keywords: Bevacizumab; Intravitreal application; Macular edema; Retinal vein occlusion; Triamcinolone.

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Figures

Fig. 1
Fig. 1
Types of occlusion in patient groups. CRVO = central retinal vein occlusion; BRVO = branch retinal vein occlusion
Fig. 2
Fig. 2
Visual acuity changes (Snellen visual acuity) in bevacizumab group.
Fig. 3
Fig. 3
Visual acuity changes (Snellen visual acuity) in triamcinolone group.
Fig. 4
Fig. 4
Visual acuity changes (Snellen visual acuity) in bevacizumab plus triamcinolone group.
Fig. 5
Fig. 5
Qualitative shift in visual acuity between first and third visit. VA = visual acuity
Fig. 6
Fig. 6
Change in central macular thickness (CMT) across three patient groups.
Fig. 7
Fig. 7
Comparison of mean intraocular pressure values (mm Hg) among groups.
See this image and copyright information in PMC

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