Prognostic Factors for Visual Outcome after Intravitreal Triamcinolone/Bevacizumab for Macular Edema Due to Central Retinal Vein Occlusion

Shirley Xiaoyan Ding, MD.PhD, Jiaqing Li, MD. PhD, Jing Zeng, MD, Jianying Pan, MD, Shanshan Yu, MD, hibo Tang*, MD.PhD

PURPOSE:
To evaluate predictive factors for final visual recovery after intravitreal injections of bevacizumab(IVB) or triamcinoline acetonide(IVT) in patients with macular edema (ME) secondary to CRVO.

METHODS:
32 consecutive eyes with ME secondary to CRVO were treated with IVB/IVT and were followed up 12 months. The corrections between age, duration, initial VA, responses to the initial injection and final visual improvement were reviewed. Patients were divided into two groups according to the final visual gain, Group 1 "well gainers" and Group 2 "poor gainer". Age, number of injections, VA improvement, and CMT resolution were compared between two groups.

RESULTS:
Duration, baseline CMT, CMT resolution showed no correlation with final VA improvement in this study. VA gain 1 month was significantly associated with a better final VA gain. Baseline VA is lower in Group 1 than that in Group 2, although no statistical significance was found. Macular ischemia was more frequent in Group 2. Visual gain 1 month after initial treatment was significant higher in Group 1.
We also noticed that macular ischemia was a more clinical pathological entity featured in the the Group 2 compared with Group I

CONCLUSIONS:
Patients with low baseline VA and with no macular edema seem to benefit most from IVB/IVT injections. The initial clinical response to the first injection is the key indicator in determining the final visual outcome.