Intravitreal triamcinolone for acute branch retinal vein occlusion: a randomized clinical trial

ABSTRACT

To evaluate the therapeutic effect of intravitreal triamcinolone [IVT] injection for recent branch retinal vein occlusion [BRVO]. In a randomized controlled clinical trial, 30 phakic eyes with recent [less than 10 weeks' duration] BRVO were assigned to two groups. The treatment group [16 eyes] received 4 mg IVT and the control group [14 eyes] received subconjunctival sham injections. Changes in visual acuity [VA] were the main outcome measure. VA and central macular thickness [CMT] changes were not significantly different between the study groups at any time point. Within group analysis showed significant VA improvement from baseline in the IVT group up to three months [P < 0.05]; the amount of this change was 0.53 +/- 0.46, 0.37 +/- 0.50, 0.46 +/- 0.50, and 0.29 +/- 0.45 logMAR at 1, 2, 3, and 4 months, respectively. Corresponding VA improvements in the control group were 0.20 +/- 0.37, 0.11 +/- 0.46, 0.25 +/- 0.58, and 0.05 +/- 0.50 logMAR [all P values > 0.05]. Significant reduction in CMT was noticed only in the treatment group [-172 +/- 202 micro m, P = 0.029] and at 4 months. Ocular hypertension occurred in 4 [25%] and 2 [14.3%] eyes in the IVT and control groups, respectively. A single IVT injection had a non-significant beneficial effect on VA and CMT in acute BRVO as compared to the natural history of the condition. The 3-month deferred treatment protocol advocated by the Branch Vein Occlusion Study Group may be a safer option than IVT injection considering its potential side effects