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ORIGINAL RESEARCH ARTICLE
Year : 2018  |  Volume : 5  |  Issue : 2  |  Page : 35-40

Intravitreal dexamethasone implant versus triamcinolone acetonide for macular edema due to central retinal vein occlusion: Quantifying efficacy and safety


1 Department of Ophthalmology, Military Hospital, Jabalpur, Madhya Pradesh, India
2 Army Hospital Research and Referral, Delhi Cantt, New Delhi, India

Correspondence Address:
Dr. Sanjay K Mishra
Department of Ophthalmology, Military Hospital, Jabalpur - 482 001, Madhya Pradesh
India
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DOI: 10.4103/bijo.bijo_2_18

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Background: Central Retinal vein occlusion (CRVO) is one of the commonest retinal vascular disease in Diabetics. Intravitreal corticosteroids (IVS) implants and injection are gaining popularity in managing Macular Edema (ME) of RVO. Objective: To assess Intravitreal Dexamethasone Implant versus Triamcinolone Acetonide for Macular Edema due to Central Retinal Vein Occlusion: regarding Efficacy and Safety. Materials and Methods: In a hospital-based prospective, comparative study, a single 0.7 mg IVD Ozurdex Implant compared to single injection of 1.0 mg IVTA for ME due to CRVO: regarding Efficacy and Safety. 40 patients, were involved between September 2012 and May 2014. In 5 follows-up Results; up to 24 months; were evaluated clinically and by fundus fluorescein angiography (FFA) beside optical coherence tomography (OCT) with significant cystoid ME as defined by CRVO study. Results: IVD implant and IVTA both were effective in restoring vision in patients of early CRVO, with a high proportion (40%) gaining ≥3 lines. In terms of safety, drug-induced IOP rise 35% lesser with IVD compared than IVTA. 67% requiring combination of anti-glaucoma medications up to at 6 months. Cataract progression and propensity for cataract surgery is 25% and 100% lesser with IVD implant at same period. The as was the gain in the BCVA and at the end of 6 months (P = 0.582), were similar in both groups. Central Macular Thickness (CMT) decreased significantly in both groups, from 551 ± 17.16 μm to 237 ± 20.71 μm in the IVD-group (P < 0.001) and from 547.5 ± 13.79 μm to 232.6 ± 18.54 μm in the IVTA-group (P = 0.001) at the end of 6 months; thus, at the final follow-up, CMT was similar in both groups (P = 0.4244). Conclusion: Intravitreal steroids are effective in managing ME of RVO, while the newer formulation of sustained-release dexamethasone implant is significantly safer than IVTA.


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