The comparison of intravitreal triamcinolone and bevacizumab in patients with macular edema secondary to branch retinal vein occlusion

Gokcen Gokce,1 Gungor Sobaci,2 Ali Hakan Durukan,2 Fazil Cuneyt Erdurman31Department of Ophthalmology, Sarikamis Military Hospital, Kars, Turkey; 2Faculty of Medicine, Department of Ophthalmology, Gulhane Military Medical Academy, Ankara, Turkey; 3Department of Ophthalmology, Canakkale Military Hospital, Canakkale, TurkeyPurpose: This study was conducted to compare the efficacy and safety of intravitreal triamcinolone acetonide (IVTA) and intravitreal bevacizumab (IVB) in the treatment of macular edema related to branch retinal vein occlusion (BRVO), using the new optical coherence tomography parameters.Material and methods: The medical records of 62 patients (IVTA n=26; IVB n=36) with macular edema secondary to BRVO and at least 12 months follow-up between 2007 and 2011 were evaluated by within-group and inter-group comparisons.Results: Both groups were similar in terms of demographic characteristics (P>0.05). Best corrected visual acuity (BCVA) improvement and central subfoveal thickness (CST) reduction were significantly higher in the IVTA group at only the third month (P<0.05). In nonischemic BRVO, while BCVA improvement was significantly higher in the IVTA group at the third and sixth months (P<0.05), no significant difference was found in CST reduction at all visits (P>0.05). In ischemic BRVO, no significant difference was found in BCVA improvement at all visits, but CST reduction was significantly higher in the IVTA group at the first and third months. Logarithmic optical coherence tomography change (LogOCTc) and relative change in retinal thickness (RCRT) showed the same levels of significance in the comparisons. Relative change in retinal thickening (RCRTing) was more valuable compared to the other parameters in the subgroup analyses.Conclusion: There was no difference between groups at the 12th month. IVTA was more efficient than IVB in regard to BCVA improvement in nonischemic BRVO in the early follow-up. IVTA made significant retinal thinning compared to IVB in ischemic BRVO in the early period. RCRTing and LogOCTc are important parameters used to monitor the response to treatment in BRVO. Because of the similar levels of significance, RCRT and LogOCTc can be used interchangeably.Keywords: branch retinal vein occlusion, bevacizumab, macular edema, triamcinolon

Therapy of Ocular Behçet Disease

Ocular involvement in Behcet disease (BD) is characterized by recurrent inflammatory attacks and spontaneous resolution of acute inflammatory signs. Both frequency and severity of uveitis attacks determine the magnitude of irreversible damage to intraocular structures and long-term visual prognosis. Recurrent attacks of occlusive retinal vasculitis lead to vision-threatening complications such as cystoid macular edema, retinal neovascularization, optic atrophy and retinal atrophy. This manuscript updates about the role of various drugs in the management of BD, discussing corticosteroids, disease modifying immunosuppressive drugs, and finally biologicals (anti-TNF-blocking agents and alpha interferon) which seem to be superior compared to all other available drugs in preventing loss of vision. Also recent findings from new biologicals will be summarized, and especially the role of these drugs in children will be discussed in detail. The authors suggest that at least moderate to severe retinal involvement should become treated with biologicals whenever available