Comparison of Clinical Efficacy of Intravitreal Ranibizumab with and without Triamcinolone Acetonide in Macular Edema Secondary to Central Retinal Vein Occlusion

Purpose: To compare visual outcomes and spectral-domain optical coherence tomography results following treatment with intravitreal ranibizumab (IVR) or IVR combined with intravitreal triamcinolone acetonide (IVTA) for macular edema (ME) secondary to central retinal vein occlusion (CRVO). Methods: This prospective, case-controlled study examined 57 eyes (57 patients) with ME secondary to CRVO, which were treated with IVR (0.5 mg, n = 30 eyes) or IVR (0.5 mg) and IVTA (1 mg, n = 27 eyes) as the initial therapy. Further intravitreal treatment was administered as necessary. Results: All 57 patients completed at least 6 months of follow-up. At baseline, mean (+/- standard error) best-corrected visual acuity (BCVA) was 45.8 +/- 23.2 letters in the IVR group and 47.3 +/- 19.3 letters in the IVR + IVTA group (p = 0.790). Significant improvement in BCVA over baseline was observed in both groups at all six study visits (IVR group: p = 0.0003, 0.0001, 0.0018, 0.0145, 0.0107, 0.005; IVR + IVTA group: p = 0.0001, 0.0001, 0.0004, 0.0068, 0.0007, 0.0002), with no significant BCVA differences between groups. Significant reduction in mean central subfield thickness, compared with baseline, was also observed in both groups at all six study visits (IVR group, p = 0.0001; IVR + IVTA group, p = 0.0001), with no significant difference between groups in the magnitude of macular thickness reduction. The mean number of injections was significantly higher (p = 0.0001) in the IVR group (4.23 +/- 0.56) than in the IVR + IVTA group (3.42 +/- 0.41). Conclusions: Treating ME secondary to CRVO with IVR or IVR + IVTA had similar effects on central macular thickness and BCVA in patients with ME secondary to CRVO over a 6-month follow-up period. The mean number of intravitreal injections was higher in the IVR group than in the IVR + IVTA group.