EFFICACY OF COMBINED INTRAVITREAL INJECTIONS OF BEVACIZUMAB AND TRIAMCINOLONE ACETONIDE IN PATIENTS WITH NON-RESOLVING MACULAR EDEMA SECONDARY TO BRANCH RETINAL VEIN OCCLUSION

Abstract

Purpose: To study the effects of combined intravitreal injections of bevacizumab (IVB) and triamcinolone acetonide (IVTA) in patients with non-resolving macular edema (ME) secondary to Branch Retinal Vein Occlusion (BRVO). Methods: In a prospective observational study, 50 pseudophakic eyes of BRVO patients with non-resolving central macular edema who had received more than 3 doses of IVB previously were injected with combination therapy of 1.25 mg/0.05 ml IVB and 4 mg of IVTA and followed up for 6 months with best corrected visual acuity(BCVA), intraocular pressure(IOP) and central macular thickness(CMT) Results: The mean BCVA was logMAR 0.75±0.25 at baseline and 0.65±0.15, 0.48±0.20, and 0.22±0.25 at 6weeks, 3 months and 6 months respectively. Mean CMT at baseline was 668.32±254.66 and 434.43±99.55, 243.22±58.92, and 220.83±42.60 at 6 weeks, 3 months and 6 months respectively. Baseline IOP measured was 16.5±3.1 mmHg which progressed to 19.6±3.4mmHg and 21.4±2.8mmHg at 6 weeks and 3 months respectively and decreased to 17.3±2.2 at 6 months. The most common adverse effect seen was increase in IOP in 24(48%)patients, out of which 3(6%) patients needed to start anti-glaucoma medication (AGM). 3(6%) patients had sub-conjunctival hemorrhage(SCH). Conclusion: The prolonged therapeutic effects of combination therapy leads to outstanding anatomical and visual outcome in non resolving ME due to BRVO, with fewer doses and thus fewer adverse effects.