The Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, 134 Shinchon-dong, Sodaemoon-gu, Seoul, 120-752, Korea.
Graefes Arch Clin Exp Ophthalmol. 2010 Jul;248(7):963-71. doi: 10.1007/s00417-010-1320-2. Epub 2010 Feb 25.
To compare visual outcomes after intravitreal triamcinolone acetonide (IVTA) injection and intravitreal bevacizumab (IVB) administration for treatment of macular edema associated with branch retinal vein occlusion (BRVO).
A retrospective comparative case series of 134 consecutive patients that were treated with either IVTA or IVB for macular edema caused by BRVO. Visual acuity at baseline and 1, 3, 6, 9, and 12 months, and central macular thickness measured by OCT at baseline and 1, 3, 6, and 12 months. The time to recurrence of macular edema after treatment was also analyzed.
Visual acuity (Snellen equivalent) improved significantly from 0.87 logMAR (0.14) to 0.49 logMAR (0.33) in the IVTA group, and from 0.91 logMAR (0.13) to 0.45 logMAR (0.36) in the IVB group 12 months after injection (p < 0.001). Central macular thickness decreased significantly from 491.0 microm to 255.8 microm in the IVTA group, and from 477.4 microm to 218.9 microm in the IVB group 12 months after injection (p < 0.001). In between-group comparisons, neither visual acuity (p = 0.892) nor macular thickness (p = 0.612) improvements were statistically significantly different. In the IVTA-all group, recurrence of macular edema occurred in 7.6% of patients at a mean of 12.6 months postoperatively, and the average number of injections was 1.08. In the IVB-all group, 26.0% of patients suffered recurrences at a mean of 5.3 months after treatment, and received a mean of 1.89 injections. Recurrence was more frequent in the IVB group compared to the IVTA group (Kaplan-Meier survival analysis log-rank test, p < 0.0001).
IVTA and IVB injections were similarly effective for improving visual acuity in patients with macular edema secondary to BRVO. However, the IVTA group showed longer mean improvement duration and less disease recurrence, and required fewer injections than the IVB group.
比较玻璃体内曲安奈德（IVTA）注射和玻璃体内贝伐单抗（IVB）给药治疗视网膜分支静脉阻塞（BRVO）相关黄斑水肿的视力结果。
对 134 例连续接受 IVTA 或 IVB 治疗 BRVO 引起的黄斑水肿的患者进行回顾性对比病例系列研究。在基线和 1、3、6、9 和 12 个月时测量视力（Snellen 等效值），并在基线和 1、3、6 和 12 个月时通过 OCT 测量中央黄斑厚度。还分析了治疗后黄斑水肿复发的时间。
IVTA 组视力（对数最小分辨角对数）从基线时的 0.87 logMAR（0.14）显著改善至 12 个月时的 0.49 logMAR（0.33），IVB 组从 0.91 logMAR（0.13）显著改善至 0.45 logMAR（0.36）（p<0.001）。IVTA 组中央黄斑厚度从基线时的 491.0μm 显著下降至 12 个月时的 255.8μm，IVB 组从基线时的 477.4μm 显著下降至 12 个月时的 218.9μm（p<0.001）。两组间比较，视力（p=0.892）和黄斑厚度（p=0.612）改善均无统计学显著差异。在 IVTA 组中，7.6%的患者在术后平均 12.6 个月时出现黄斑水肿复发，平均注射次数为 1.08 次。在 IVB 组中，26.0%的患者在治疗后平均 5.3 个月时出现复发，平均注射次数为 1.89 次。与 IVTA 组相比，IVB 组的复发更为频繁（Kaplan-Meier 生存分析对数秩检验，p<0.0001）。
玻璃体内曲安奈德（IVTA）和贝伐单抗（IVB）注射治疗 BRVO 相关黄斑水肿患者的视力提高效果相似。然而，IVTA 组的平均改善持续时间更长，疾病复发更少，所需注射次数也少于 IVB 组。
