Intravitreal Triamcinolone for Acute Branch Retinal Vein Occlusion: a Randomized Clinical Trial

To evaluate the therapeutic effect of intravitreal triamcinolone (IVT) injection for recent branch retinal vein occlusion (BRVO). In a randomized controlled clinical trial, 30 phakic eyes with recent (less than 10 week's duration) BRVO were assigned to two groups. The treatment group (16 eyes) received 4 mg IVT and the control group (14 eyes) received subconjunctival sham injections. Changes in visual acuity (VA) were the main outcome measure. VA and central macular thickness (CMT) changes were not significantly different between the study groups at any time point. Within group analysis showed significant VA improvement from baseline in the IVT group up to three months (P < 0.05); the amount of this change was 0.53 ± 0.46, 0.37 ± 0.50, 0.46 ± 0.50, and 0.29 ± 0.45 logMAR at 1, 2, 3, and 4 months, respectively. Corresponding VA improvements in the control group were 0.20 ± 0.37, 0.11 ± 0.46, 0.25 ± 0.58, and 0.05 ± 0.50 logMAR (all P values > 0.05). Significant reduction in CMT was noticed only in the treatment group (172 ± 202 microns, P = 0.029) and at 4 months. Ocular hypertension occurred in 4 (25%) and 2 (14.3%) eyes in the IVT and control groups, respectively. A single IVT injection had a non-significant beneficial effect on VA and CMT in acute BRVO as compared to the natural history of the condition. The 3-month deferred treatment protocol advocated by the Branch Vein Occlusion Study Group may be a safer option than IVT injection considering its potential side effects.