Efficacy and Safety of Intravitreal Triamcinolone Acetonide Alone or Combined with Intravitreal Bevacizumab in the Treatment of Macular Edema Secondary to Branch Retinal Vein Occlusion

OBJECTIVES: To compare the efficacy and safety of intravitreal triamcinolone acetonide (IVTA) monotherapy versus combined intravitreal triamcinolone acetonide and bevacizumab (IVTA+IVB) therapy in the treatment of macular edema secondary to branch retinal vein occlusion (BRVO).
METHODS: In this retrospective study, 66 eyes of 65 patients with BRVO-related macular edema were evaluated. Patients were divided into two groups: IVTA monotherapy (n=37) and IVTA+IVB combination therapy (n=29). Central macular thickness (CMT), best-corrected visual acuity (BCVA), and intraocular pressure (IOP) were measured at baseline, week 1, and months 1, 3, and 6 after injection.
RESULTS: Both groups demonstrated significant improvements in BCVA and reductions in CMT compared with baseline (p<0.001), with no statistically significant differences between the groups at any follow-up time point. IOP was significantly elevated in the IVTA group at several time points (p<0.05), while the combination group showed stable IOP levels. New-onset glaucoma developed in 8 patients in the IVTA group and only 1 patient in the combination group. No serious ocular complications occurred in either group.
DISCUSSION AND CONCLUSION: Both treatment regimens provided comparable anatomical and visual improvements; however, combination therapy was associated with a more favorable safety profile. Although the use of IVTA has declined in contemporary clinical practice in favor of intravitreal dexamethasone implants, this study suggests that IVTA alone or in combination may still offer a viable and cost-effective alternative in regions where access to current therapies is limited or in low-resource settings.

Keywords: Bevacizumab, branch retinal vein occlusion, cost-effective therapy, macular edema, triamcinolone acetonide