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B. T. Chan-Kai, P. E. Carvounis, R. P. A. Manzano, J. A. Fortun, H. H. Kim, T. A. Albini, A. C. Kopel, E. C. Holz; Factors Influencing Visual Outcomes Following Treatment for Retinal Pigment Epithelium Detachment Associated With Age-Related Macular Degeneration. Invest. Ophthalmol. Vis. Sci. 2007;48(13):3390.
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To analyse factors that may influence visual outcomes following treatment with intravitreal triamcinolone acetonide (IVTK) or photodynamic therapy (PDT) or their combination for retinal pigment epithelium detachment (PED) related to age-related macular degeneration (ARMD).
Retrospective, interventional, comparative study of 33 eyes of 31 patients treated with PDT, IVTK or PDT+IVTK for ARMD-related PEDs measuring at least 1000um. Univariate analysis was performed to identify factors that may influence 6 and 12-month visual outcomes.
The presence of lipid, hemorrhage or subretinal fluid prior to initiation of treatment was associated with a significantly worse mean visual acuity at 12 months (logMAR 1.15 compared to 0.72 if absent, p=0.03) although there was no significant difference at baseline (p=0.72) or 6 months (p=0.66). The mean visual acuity was similar at both 6 and 12 months irrespective of patient gender (p=0.85 and 0=0.65 respectively), of patient age greater or less than 79 (p=0.63 and 0.51 respectively), of whether the size of the PED was greater or smaller than 1.5 disc diameters (p=0.53 and 0.35 respectively), or of the presence or absence of evidence of choroidal neovascularization (CNVM) on fluorescein angiography at baseline (p= 0.92 and p=0.51 respectively).
Visual outcomes following treatment of PED with PDT, IVTK or PDT+IVTK are independent of patient gender, age, size of PED or fluorescein angiographic evidence of CNVM. Clinical evidence of active CNVM is a significant predictor of 12 month visual outcome.
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