الفهرس | Only 14 pages are availabe for public view |
Abstract Retinal vein occlusion is one of the vascular disorders affecting vision. Branch retinal vein occlusion is three times more common than central retinal vein occlusion and is second only to diabetic retinopathy as the most common retinal vascular cause of visual impairment .There are many lines of treatment to macular edema secondary to RVO. One of them is intravitreal injection of antiedematous substances such as Triamcinolone acetonide and Anti- VEGF. This study compared the effect of intravitreal injection of Triamcinolone acetonide , Bevacizumabe and combination of both for the treatment of macular edema secondary to retinal vein occlusion. The included patients in this study undergone full ophthalmological examination as Best corrected visual acuity measurement using snellen eye chart, Anterior segment examination using slit lamp , Intraocular pressure using Goldmann applanation tonometer, Posterior segment examination after pupillary dilatation using Slit lamp biomicroscopy with +90 and +78 diopter volk lens, Fundas flourescein angiography was done using Canon fundus camera and Optical coherence Tomography (OCT) to assess the central foveal thickness was done using Heidelberg Optical coherence tomograsphy . Then the selected patients were divided randomly into three groups : Group 1: Included 20 eyes of 19 patients with retinal vein occlusion (9 BRVO,11 CRVO) received intravitreal bevacizumab injection (IVB) 2.5 mg/0.1ml. Group 2: Included 18 eyes of 18 patients with retinal vein occlusion (10 BRVO,8 CRVO) received intravitreal triamcinolone acetonide injection (IVT) 4mg/ 0.1ml. Summary 58 Group 3: Included 17 eyes of 17patients with retinal vein occlusion (9 BRVO,8 CRVO) received combined intravitreal injection of bevacizumab (Avastin) (IVB) 1.25 mg/0.05ml and triamcinolone acetonide (IVT) 2mg/0.1ml ( combined ). The patients were examined at 1,3,6 months for follow up and showed that all the three kinds of treatment resulted in significant reduction of central macular thickness throughout six months. Compared to baseline, visual acuity was significantly better in all three groups at 1,3 and 6 months. Bevacizumab monotherapy and combined groups maintained better visual acuity while the triamcinolone group did not at three and six months. At six months, only bevacizumab injected eyes showed highly significant improvement in visual acuity. The bevacizumab group showed the higher rate of re-injections but least complications compared to the other groups. |