Outcomes of Intravitreal Bevacizumab Combined with Suprachoroidal Triamcinolone Acetonide in Central Retinal Vein Occlusion with Macular Edema

Purpose:  To determine the outcomes of intravitreal Bevacizumab 1.25 mg in 0.05 ml combined with supra-choroidal triamcinolone acetonide 0.05 ml in terms of safety and efficacy, while treating macular edema associated with central retinal vein occlusion (CRVO). Study Design:  Interventional case series. Place and Duration of Study:  This study was conducted at ophthalmology department of Hayatabad medical complex, Peshawar from July 2021 to December 2021. Methods:  Total 34 patients of CRVO with macular edema were included in the study. After complete ocular examination each patient received one injection of intravitreal bevacizumab (1.25 mg/0.05 ml) along with supra-choroidal triamcinolone acetonide (2 mg/0.05 ml), followed by similar monthly injections for two months. Visual acuity and central macular thickness and intra-ocular pressure (IOP) were assessed at presentation and then monthly for 3 months. Visual acuity was measured in Log-MAR, central foveal thickness on SD-OCT and IOP was measured with Goldmann Applanation Tonometer. The data was analyzed using SPSS version 24. For comparison of means, the paired-t test was used. A significance level of <0.05 was set for significance. Results:  There were 22 (64.7%) males and 12 (35.5%) females. Mean age of the patients was 53.18 ± 13.39 years. Central foveal thickness decreased significantly at 3 months post treatment (p ˂ 0.001). Visual acuity also significantly increased from presentation to 3rd month post treatment (p ˂ 0.001), and the intra-ocular pressure remained within normal range from presentation to 3rd month post treatment. Conclusion:  Both supra-choroidal triamcinolone acetonide and intravitreal bevacizumab are safe and effective in the treatment of macular edema secondary to CRVO.