Intravitreal steroids versus observation for macular edema secondary to central retinal vein occlusion

Central retinal vein occlusion (CRVO) is the most common retinal vascular abnormality second to diabetic retinopathy. It classically presents as a unilateral painless loss of vision in individuals over the age of 40 and is associated with conditions such as high blood pressure, diabetes, glaucoma, and hematologic diseases. Macular edema (ME) is a complication of CRVO and is the primary reason for loss of vision in this condition. Currently there is no treatment for this disorder and laser treatment is not effective for CRVO-induced macular edema. Steroid injections in the eye have been used to treat macular edema caused by other eye disorders. This review aimed to examine the risks and benefits of using intravitreal steroids in treating CRVO-ME. While intravitreal steroids can lead to improvements in vision, the effect usually lasts only a few months and there is a risk of developing glaucoma, cataracts, and other complications. Due to an inadequate number of well-designed studies on the topic, we cannot make definitive conclusions and therefore the use of intravitreal steroids is still experimental. More definitive answers may appear when the results of a new randomized controlled trial (the SCORE trial) are published.