The effectiveness and reliability of posterior sub-Tenon triamcinolone acetonide injection in branch retinal vein occlusion-related macular edema

Kola, Mehmet; Hacıoğlu, Dilek; Türk, Adem; Erdöl, Hidayet

doi:10.3109/15569527.2015.1074586

Cited by 7 publications

(5 citation statements)

References 39 publications

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“…Nevertheless, we found that the effect of PSTA was no longer sustained after 3 months. Compatible with what was found by Kola et al, 34 PSTA exerted a short-term efficacy with significant visual improvement at 3 months, but disease recurred at 6 months, and the difference from baseline was no longer sustained ( p =0.846). The fading drug effect probably accounted for the observation.…”

Section: Discussionsupporting

confidence: 76%

Comparison between intravitreal bevacizumab and posterior sub-tenon injection of triamcinolone acetonide in macular edema secondary to retinal vein occlusion

Tsai

Hsieh

Peng

2018

OPTH

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AimTo compare the efficacy and safety between posterior sub-tenon injection of triamcinolone acetonide (PSTA) and intravitreal injection of bevacizumab (Avastin) (IVIA) in the treatment of macular edema secondary to retinal vein occlusion.Patients and methodsA total of 45 eyes were retrospectively enrolled (23 eyes with intravitreal bevacizumab and 22 eyes with posterior sub-tenon triamcinolone acetonide). Main endpoints included logMAR of best-corrected visual acuity (BCVA), central macular thickness (CMT), and intraocular pressure (IOP) before and after treatment at 6 months.ResultsThe mean logMAR improved from 0.78 to 0.56 at 6 months for intravitreal bevacizumab (p=0.001), and from 0.91 to 0.79 and 0.87 at 3 and 6 months (p=0.038 and 0.13), respectively, for sub-tenon triamcinolone acetonide. At 6 months, the BCVA was significantly better in the bevacizumab group (p=0.02). Both groups’ mean CMT significantly improved, from 478 µm at baseline to 295 µm at 6 months in IVIA group (p<0.001) and from 419 µm at baseline to 350 µm in PSTA group (p=0.012); however, this was not different between the groups at 6 months (p=0.065). Recurrence of macular edema was not different between the groups either (p=0.08). Poorer final vision was associated with poorer baseline BCVA and diagnosis of central retinal vein occlusion after adjustment for age and sex (p<0.001 and 0.012, respectively). Significant elevation of IOP was noted at 3 months in the PSTA group, but declined at 6 months compared with baseline (p=0.002 and 0.41, respectively).ConclusionIntravitreal bevacizumab seemed to achieve better visual acuity compared with posterior sub-tenon injections of triamcinolone acetonide at 6 months, while CMT was comparable. PSTA still resulted in transient IOP elevation.

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Section: Discussionsupporting

confidence: 76%

Comparison between intravitreal bevacizumab and posterior sub-tenon injection of triamcinolone acetonide in macular edema secondary to retinal vein occlusion

Tsai

Hsieh

Peng

2018

OPTH

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“… Non-naive 30 56.3 (8.8) 30 Prospective, multi-centre 9 Wang et al a [ 53 ] Taiwan Aflibercept 2 mg Single injection then monthly PRN regimen. Naive 50 63.3 (6.9) 48 Retrospective, single-centre 12 Kola et al a [ 40 ] Turkey Triamcinolone Acetonide 40 mg (posterior sub-tenon) Single injection. Naive 41 63.5 (11) 36.6 – 6 Buyru Özkurt et al a [ 42 ] Turkey Subthreshold macular laser Single treatment then PRN regimen.…”

Section: Resultsmentioning

confidence: 99%

A systematic review of real-world evidence of the management of macular oedema secondary to branch retinal vein occlusion

Ang

Ah-Moye

Kim

et al. 2020

Eye

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This review assessed the real-world evidence of the management of macular oedema secondary to branch retinal vein occlusion (BRVO). A meta-analysis of 2530 eyes from 48 real-world studies of therapies for macular oedema secondary to BRVO was conducted. Baseline characteristics, visual, anatomical and safety outcomes were recorded. The weighted mean and weighted estimates from random-effects models were calculated for visual acuity (VA) and central subfield thickness (CST) changes at 6, 12 and 24 months. Primary outcome was change in VA (logMAR letters) at 12 months. Study quality was assessed using the quality appraisal checklist for case series developed by Institute of Health Economics. The mean baseline VA for the pooled data was 54.0 (51.5, 56.5) letters and the mean baseline CST was 501.3 (483.5, 519.1) µm. The random-effects estimate for mean (95% CI) change in VA was 14.6 (12.5, 16.7) letters at 12 months ( n = 1727). The random-effects estimate for mean (95% CI) change in CST was −181.7 (−230.7, −132.7) µm at 12 months ( n = 1325). The quality of studies varied considerably. Ocular and systemic adverse events were discussed in 79% and 42% of treatment arms respectively, with possible under-reporting. Visual and anatomical gains achieved in the real-world for anti-VEGF therapy were not as impressive as seminal RCTs, possibly due to reduced injection frequency in the real world and differences in baseline characteristics. There is an urgent need for consensus on the minimum efficacy, treatment burden and safety data to collect to strengthen the real-world evidence base.

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“…The most significant consequence, elevated intraocular pressure, affected 50% (two of four) patients, requiring one or more topical medications for reduction. This is higher than reported in prior studies of sub-tenon's triamcinolone monotherapy for macular edema secondary to retinal vein occlusions [7][8][9]. Due to the small sample size, however, it is unclear if the results would have been different if there was a larger patient sample.…”

Section: Discussionmentioning

confidence: 58%

“…Steroids reduce vascular permeability and also affect gene expression of inflammatory mediators [6], in addition to their ability to block VEGF. Sub-tenon's triamcinolone monotherapy has been shown to improve visual acuity at one month after administration for retinal vein occlusion, but has varying efficacy in regard to OCT thickness reduction [7][8][9]. These studies have shown rates of IOP elevation from 5%-29% of patients treated with posterior sub-tenon's triamcinolone monotherapy for macular edema secondary to retinal vein occlusion.…”

Section: Discussionmentioning

confidence: 99%

Same Day Sub-tenon’s Triamcinolone and Anti-VEGF Injections in Patients with Macular Edema Secondary to Central Retinal Vein Occlusion

Yamanuha¹,

Flock²

2018

Arch Clin Med Case Rep

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Purpose: Sub-tenon's or suprachoroidal triamcinolone have been shown to effectively reduce macular edema and extend anti-vascular endothelial factor (anti-VEGF) interval in patients with macular edema from retinal vein occlusions [1,2]. This single site retrospective review was conducted to determine if this combination treatment could achieve similar benefits and also improve visual acuity in patients treated for central retinal vein occlusion (CRVO). Methods:The Mayo Clinic Institutional Review Board (IRB) granted approval for the retrospective review of patients treated with simultaneous same day anti-VEGF and sub-tenon's triamcinolone acetonide injections for macular edema secondary to CRVO at the Mayo Clinic Health System in La Crosse, Wisconsin. Patients were excluded if the prior treatment history was unknown or if follow up did not occur after three months.Primary Outcomes: Visual acuity, intraocular pressure, optical coherence tomography (OCT) thickness, and anti-VEGF injection interval were analyzed at treatment day and three months.

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The effectiveness and reliability of posterior sub-Tenon triamcinolone acetonide injection in branch retinal vein occlusion-related macular edema

Abstract: PSTA application is an effective and safe option in BRVO-related macular edema.

Cited by 7 publications

References 39 publications

Comparison between intravitreal bevacizumab and posterior sub-tenon injection of triamcinolone acetonide in macular edema secondary to retinal vein occlusion

Comparison between intravitreal bevacizumab and posterior sub-tenon injection of triamcinolone acetonide in macular edema secondary to retinal vein occlusion

A systematic review of real-world evidence of the management of macular oedema secondary to branch retinal vein occlusion

Same Day Sub-tenon’s Triamcinolone and Anti-VEGF Injections in Patients with Macular Edema Secondary to Central Retinal Vein Occlusion

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