Intravitreal Triamcinolone Acetonide Combined With Subthreshold Grid Laser Treatment for Macular Edema in Branch Retinal Vein Occlusion

Purpose: To evaluate the effects of the therapy combining intravitreal triamcinolone injection (IVT) and subthreshold grid laser treatment with infrared micropulse 810 nm diode laser for macular edema secondary to branch retinal vein occlusion (BRVO). Methods: Prospective interventional case series, including 11 patients (11 eyes) with macular edema secondary to BRVO. All the patients received IVT (4 mg) and 3 weeks later underwent infrared subthreshold (no intraoperative visible endpoint) grid laser treatment. Best–corrected visual acuity with ETDRS charts, foveal thickness measured by optical coherence tomography, fluorescein angiography, and intraocular pressure were evaluated at baseline and at each follow–up examination. Main outcome measures were the changes of at least 2 lines of visual acuity and the foveal thickness reduction of at least 25% from the baseline values. The follow–up ranged from 8 to 12 months (mean: 8,9 months). Results: At the end of the follow–up an improvement of at least 2 lines of best–corrected visual acuity was registered in 9 eyes (82%). Foveal thickness improved in 9 eyes (82%), with an overall change from a mean initial value of 479µ to a mean final value of 259µ. Four eyes (36%) developed an intraocular pressure rise over 22 mmHg requiring glaucoma therapy. No patient revealed cataract progression. Conclusions: Combined therapy of IVT and subthreshold grid laser treatment with infrared micropulse 810 nm diode laser is an effective treatment in improving visual function in patients affected by macular edema associated with BRVO.