Do Triamcinolone Injections Improve Vision After Central Retinal Vein Occlusion?
September 17, 2009
According to two reports in the September issue of Archive of Ophthalmology, injections with triamcinolone appear to improve the vision of some patients after a retinal vein occlusion. Researchers found that 1 mg injection might improve the vision of patients with central retinal vein occlusions (CRVO) more than in those patients with branch retinal vein occlusions (BRVO).
In the first paper, the SCORE (Standard Care vs. Corticosteroid for Retinal Vein Occlusion) Study Research Group conducted a randomized clinical trial of 271 participants with macular edema from CRVO. One group received1 milligram of intravitreal triamcinolone, another received a 4-milligram dose and another group received observation. Participants were evaluated every four months for 12 months, and those patients in the triamcinolone group received additional injections at each follow-up visit unless there was a specific reason not to re-treat.
After one year, vision improved significantly in 7 percent of those in the observation group, 27 percent of those in the 1-milligram triamcinolone group and 26 percent of those in the 4-milligram triamcinolone group. Potential adverse events such as cataract or elevated IOP were similar for the observation and 1-milligram group but higher for the 4-milligram group. The authors conclude that the 1 mg injections were superior to observation in patients with criteria similar to those in this study group.
In the other report, the researchers compared 1- and 4-mg injections of triamcinolone with the current standard of care of grid photocoagulation in patients with BRVOs. A group was assigned to receive standard care, another received a 1-milligram dose and the final group received a 4-milligram dose. Similar to the central retinal occlusion trial, participants were evaluated and re-treated as indicated every four months.
After one year, 29 percent of participants in the standard care group, 26 percent in the 1-milligram triamcinolone group and 27 percent in the 4-milligram group experienced improved vision. Adverse events were similar between the standard care group and the injection group but with the added risk of procedure-related complications, the authors determined that the results support the continued use of grid photocoagulation as the standard of care in these patients.
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