Systematic Review Of Comparing Intravitreal Triamcinolone Acetonide Versus Bevacizumab For Macular Edema Secondary To Retinal Vein Occlusion

Object: To evaluate the effects and safety of intravitrealtriamcinolone acetonide (IVT) versus intravitreal bevacizumab (IVB) forthe treatment of macular edema (ME) secondary to retinal vein occlusion.Methods: Prospective, consecutive, clinical interventional study andretrospectively comparative interventional studys comparing intravitrealbevacizumab with intravitreal TA for the treatment of macular edemaresulting from RVO were searched in CCTR, Pubmed, Embase, CNKIand CBM-disc. Moreover, The Science Citation Index (SCI) and handsearching were also conducted. A meta-analysis were performed tocompare best corrected visual acuity (BVCA) change, Central macularthickness change between the two operations.Results: One Prospective, consecutive, clinical interventional studyand six retrospectively comparative interventional studys with a total of 307participants were included. Primary outcome was BCVA change andCMT change, and in the meta analysis,in the BCVA change, one monthlater, the mean difference was0.02,95%CI (-0.07,0.10)；three monthlater, the mean difference was-0.03,95%CI(-0.18,0.13), six month later,the mean difference was0.06，95%CI(-0.13，0.25)，nine month later,the mean difference was0.07，95%CI(-0.07，0.20); This suggests thatbetween IVB and IVT, no statistical differences were found in best-corrected visual acuity measurement between the two treatment groups。In the CMT change on：one month later, the mean difference was-2.99，95%CI(-34.9，28.91)；three month later, the mean difference was103.25,95%CI(-25.57，232.07)，six month layer, the mean differencewas13.27,95%CI(-116.71，143.25)，nine month layer, the meandifference was-1.93,95%CI(-11.26，7.39);This suggests that betweenIVB and IVT, no statistical differences were found in mean centralmacular thickness measurement between the two treatment groups. In thehigh intraocular pressure on:one month later, the mean difference was-2.77，95%CI (-4.61，-0.93),three month later, the mean difference was-2.87，95%CI(-4.41，1.32), six month later, the mean difference was4.21，95%CI(-6.99，-1.42);This suggests that The IOP after intravitrealtriamcinolone acetonide injection increase significantly after1,3,6months, but decreased to baseline after9months; In contrast, no increasein IOP was seen afte bevacizumab Injection. Conclusions: Both IVT and IVB treatments can effectively improvebest-corrected visual acuity and reduce central macular thickness inpatients with ME secondary to retinal vein occlusion;no statisticaldifferences were found in either best-corrected visual acuity or meancentral macular thickness measurement between the two treatment groups.However, triamcinolone acetonide causes more adverse events thanbevacizumab.There are some limitations in this study. A deficiency of the studywas the limited number of cases, One may suspect that some non-signi-ficant results in the present study will change if more patients are enrolled.Another deficiency of the study was no high quality RCTs were foundyet.So, further studies are needed to determine.