Combined treatment of intravitreal bevacizumab and intravitreal triamcinolone in patients with retinal vein occlusion: 6 months of follow-up

To report 6 months of results of combined treatment of intravitreal bevacizumab and triamcinolone in patients with retinal vein occlusion (RVO). Retrospective consecutive case series. Intravitreal bevacizumab (1.25 mg) combined with intravitreal triamcinolone (2 mg) was injected to 16 patients with RVO: eight with branch retinal vein occlusion (BRVO) and eight with central retinal vein occlusion (CRVO). Patient's charts were reviewed for age, sex, previous ocular interventions, duration of follow-up, number of intraocular injections, intraocular pressure (IOP) and central macular thickness measured by optical coherence tomography (OCT). We included only patients that completed 6 months of follow-up. Mean age and number of injections were 72.9 +/- 11.99 years, and 2 +/- 0.81 respectively. In eight patients with CRVO, initial visual acuity was logMAR 1.09 +/- 0.67 and mean visual acuity at 1, 3 and 6 months was logMAR 0.98 +/- 0.55 (p = 0.59), 1.33 +/- 1.05 (p = 0.4) and 1.4 +/- 1.2 (p = 0.34) respectively. In eight patients with BRVO, initial visual acuity was logMAR 1.025 +/- 0.58 and mean visual acuity at 1, 3, and 6 months was 0.56 +/- 0.21 (p = 0.05), 0.61 +/- 0.17 (p = 0.03) and 0.66 +/- 0.34 (p = 0.12) respectively. Mean initial central macular thickness for the whole group was 527 +/- 182 mu m and mean central macular thickness at 6 months was 379 +/- 156 mu m (p < 0.001). This study suggests that combined treatment with intravitreal bevacizumab and intravitreal triamcinolone improves structural outcome in patients with retinal vein occlusion. In our study, the combination of triamcinolone acetonide and bevacizumab offered no advantage over previously published results with intravitreal bevacizumab injections alone for improving vision at 6 months.