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K. M. Kulkarni, D. B. Roth, W. J. Feuer; The Temporal Sequence of Combined Intravitreal Triamcinolone Acetonide and Photodynamic Therapy for Exudative Age-Related Macular Degeneration. Invest. Ophthalmol. Vis. Sci. 2007;48(13):1789.
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To compare visual outcomes in patients with exudative age-related macular degeneration (AMD) who were treated with intravitreal triamcinolone acetonide (IVTA) either one week before or on the same day of photodynamic therapy (PDT) with verteporfin.
61 eyes of 60 patients with exudative AMD were treated with IVTA combined with PDT at a single vitreoretinal practice. The 1 Week Prior group consisted of eyes that received IVTA one week prior to PDT. The Same Day group consisted of eyes that received IVTA followed by PDT the same day. No restriction as to the type of CNV (predominantly classic, classic, minimally classic, or occult) or size of the lesion was made. Proportions were compared between the groups with the Chi-square or Fisher's exact test as appropriate. Means were compared with the independent samples t-test, and comparison of the visual results between the two groups after adjusting for important covariates was performed using multiple linear regression.
There were 31 eyes in the 1 Week Prior group and 30 eyes in the Same Day group. Twenty-eight of 31 (90.3%) eyes in the 1 Week Prior group and 28 of 30 (93.3%) eyes in the Same Day group completed the 1 year follow-up. There was no statistically significant difference in VA between the groups at baseline, 6-12 week, or 1 year (Table). When the VA outcomes were adjusted for baseline VA, spot size, lesion type, age, and gender, there was no statistical difference in VA between the groups at either 6-12 weeks (P = 0.44) or 1 year (P = 0.28).
There appears to be no significant difference in visual outcomes in eyes that receive IVTA one week prior to PDT vs. eyes that receive IVTA and PDT on the same day for the treatment of exudative AMD. Further investigation into the optimal temporal sequence of treatment is required to exclude a difference.
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