Chen Chih-Hsin, Chen Yi-Hao, Wu Pei-Chang, Chen Yung-Jen, Lee Jong-Jer, Liu Ya-Chi, Kuo Hsi-Kung
Department of Ophthalmology, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan.
Chang Gung Med J. 2010 Jul-Aug;33(4):424-35.
To evaluate the effects of a single intravitreal injection of triamcinolone acetonide (ivTA) or bevacizumab (ivBe) on visual acuity and central macular thickness (CMT) in cases of macular edema secondary to branch retinal vein occlusion (BRVO) for eyes that are treatment-naïve.
This consecutive, retrospective, nonrandomized, clinical interventional study included 83 patients (83 eyes) with macular edema secondary to BRVO who received single ivTA (25 patients) or ivBe (24 patients) injections, or no treatment (controls, 34). The main outcomes included CMT measurements using optical coherence tomography (OCT) and best-corrected visual acuity (BCVA).
CMT decreased significantly from baseline at 4, 8, 12 and 24 weeks after treatment (p < 0.05) in both the intravitreal groups and the control group. BCVA improved significantly from baseline at 4 and 8 weeks after treatment among the ivTA group (p < 0.05) and at 4, 8 and 12 weeks after treatment among the ivBe group (p < 0.05). Comparing CMT between the groups, significant differences were found between ivTA and control groups and ivBe and control groups at the 4- and 8- week checkpoints (p < 0.05). Significant differences were found in BCVA only between ivBe and control groups at the 8-week checkpoint (p = 0.049). No significant differences were found for CMT and BCVA between the ivBe and ivTA groups (p > 0.05) at any checkpoint after treatment. No patient experienced immediate procedure-related complications or any obvious systemic adverse events in either the ivTA group or the ivBe group. Delayed complications included steroid induced ocular hypertension in eight eyes (32%) and development of posterior subcapsular cataracts in five eyes (28%) in the ivTA group.
Both the ivTA and ivBe therapies were beneficial short-term treatment options for the treatment of macular edema secondary to BRVO. However, the ivBe treatment appears to be safer and less prone to adverse side effects such as ocular hypertension and cataract compared with ivTA therapy.
评估单次玻璃体内注射曲安奈德（ivTA）或贝伐单抗（ivBe）对初治的视网膜分支静脉阻塞（BRVO）继发黄斑水肿患者视力和中心黄斑厚度（CMT）的影响。
这项连续、回顾性、非随机临床干预研究纳入了83例（83只眼）BRVO继发黄斑水肿的患者，其中25例接受单次ivTA注射，24例接受单次ivBe注射，34例未接受治疗（对照组）。主要观察指标包括使用光学相干断层扫描（OCT）测量CMT以及最佳矫正视力（BCVA）。
治疗后4、8、12和24周，玻璃体内注射组和对照组的CMT均较基线显著降低（p<0.05）。ivTA组治疗后4周和8周BCVA较基线显著改善（p<0.05），ivBe组治疗后4、8和12周BCVA较基线显著改善（p<0.05）。组间CMT比较，在4周和8周检查点时，ivTA组与对照组、ivBe组与对照组之间存在显著差异（p<0.05）。仅在8周检查点时，ivBe组与对照组的BCVA存在显著差异（p=0.049）。治疗后任何检查点，ivBe组与ivTA组之间的CMT和BCVA均无显著差异（p>0.05）。ivTA组和ivBe组均无患者出现与手术相关的即刻并发症或任何明显的全身不良事件。延迟并发症包括ivTA组8只眼（32%）出现类固醇性高眼压，5只眼（28%）发生后囊下白内障。
ivTA和ivBe疗法都是治疗BRVO继发黄斑水肿的有益短期治疗选择。然而，与ivTA疗法相比，ivBe治疗似乎更安全，更不易出现高眼压和白内障等不良反应。
