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H. Wafapoor, A. M. Eaton; High Dose Juxta-Scleral Triamcinolone Combined With Intraocular Avastin in the Treatment of Neovascular Age Related Macular Degeneration. Invest. Ophthalmol. Vis. Sci. 2007;48(13):1790.
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© ARVO (1962-2015); The Authors (2016-present)
To determine if high dose juxtascleral Triamcinolone (HDJXT) in combination with intraocular Avastin (IOA) is safe and effective in the treatment of patients with neovascular age related macular degeneration (AMD).
: A retrospective chart review of patients that underwent an injection of 200 mg-HDJXT, in combination with 1.25 mg IOA, from August 2006 to November 2006 was performed. All eyes had complete eye exam including baseline optical coherence tomography (OCT) and Fluorescein angiography (FA).
Ten eyes were identified. Five patients were females. Age ranged from 71-89 years. Five eyes had previous treatments including Avastin, photodynamic therapy and Pegaptanib; eight eyes were pseudophakic. Prior to treatment LogMar visual acuity (VA) was 0.93±0.62, central macular thickness (CMT) on OCT was 335±88.8 microm, and GLD on FA was 4459±2390 microm. On FA 8 eyes were occult membranes, 1 eye minimally classic and 1 eye predominantly classic. On OCT 6 eyes had pigment epithelial detachment and 1 eye had RPE tear. Following treatment LogMar VA improved to 0.72±0.56. There was a 21% reduction in CMT to 263±65 microm, and the GLD was also reduced by 31% to 3049±2008 microm. Two eyes did not require re-injection of IOA, and only 1 eye required 2 further IOA injections the rest received only 1 re-injection of IOA for the length of follow-up. Mean intraocular pressure increased from 12.4±2 to 16.4±4.
: HDJXT in combination with IOA leads to the improvement of visual acuity, and the reduction of CMT and GLD by optical coherence tomography and FA examinations. This combination therapy may decrease the need for repeated IOA injections and should be considered as an alternative therapy in patients affected by neovascular AMD.
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