Curative effect of Triamcinolone acetonide combined with macular grid photocoagulation in the treatment of macular edema secondary to BRVO / 国际眼科杂志(Guoji Yanke Zazhi)

ABSTRACT

@#AIM: To analyze the efficacy and safety of triamcinolone acetonide(TA)combined with macular grid photocoagulation in the treatment of macular edema(ME)secondary to branch retinal vein occlusion(BRVO).<p>METHODS: A total of 147 patients(147 eyes)with ME secondary to BRVO treated in the hospital were enrolled between January 2016 and January 2020. They were randomly divided into observation group(73 eyes)and control group(74 eyes). The observation group was given intravitreal injection of TA and macular grid photocoagulation, while control group was given intravitreal injection of conbercept and macular grid photocoagulation. All were followed up for 6mo. Efficacy and safety indexes between the two groups were compared.<p>RESULTS:After treatment, best corrected visual acuity(BCVA, LogMAR)in both groups was improved. At 1mo after treatment, BCVA in observation group was better than that in control group(0.22±0.15 <i>vs </i>0.27±0.13, <i>P</i><0.05). At 6mo after treatment, BCVA of patients under 50 years in observation group was significantly better than that of patients under 50 years in control group(0.09±0.04 <i>vs </i> 0.14±0.06, <i>P</i><0.05).BCVA was the best in patients with type serous retinal detachment(SRD), followed by type ME and mixed type(<i>P</i><0.05). However, there was no significant difference in BCVA between any two groups in ME classifications(<i>P</i>>0.05). After treatment, central macular thickness(CMT)in both groups was significantly decreased. At 3mo after treatment, CMT in observation group was higher than that in control group(309.76±84.24μm <i>vs </i>258.75±88.76μm, <i>P</i><0.01). At 1wk, 1, 3 and 6mo after treatment, intraocular pressure in observation group was higher than that in control group(<i>P</i><0.01). At 6mo after treatment, blood flow density of superficial capillary plexus(SCP)in both groups was significantly higher than that before treatment(<i>P</i><0.05), but there was no significant change in blood flow density of deep capillary plexus(DCP)or the area of foveal avascular zone(FAZ)(<i>P</i>>0.05). The incidence of increased intraocular pressure was higher in observation group than control group(28.8% <i>vs </i>14.9%), and times of intravitreal injection were fewer than those in control group(1.21±0.74 times <i>vs </i>3.62±2.08 times).<p>CONCLUSION: TA combined with macular grid photocoagulation in the treatment of ME secondary to BRVO can maintain visual acuity at a certain level in the short term. The curative effect is comparable to that of conbercept combined with macular grid photocoagulation in terms of improving visual acuity and CMT. However, there is increased intraocular pressure, and the intraocular pressure monitoring needs to be strengthened.