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C. Jahn, II, J. Schreiber, K. Engelmann, L. Pillunat; Combined Intraviteral Triamcinolone With Photodynamic Therapy for Subfoveal Choroidal Neovascularisation in Age–Related Macular Combined Degeneration . Invest. Ophthalmol. Vis. Sci. 2006;47(13):345.
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© ARVO (1962-2015); The Authors (2016-present)
To investigate the effects of combined intravitreal triamcinolone acetonide in combination (iTAAC) with photodynamic therapy (PDT) for subfoveal choroidal neovascularisation (CNV) in age related macular degeneration (AMD) subject to the type of lesion.
We retrospectively reviewed the records of all AMD patients who were treated with an intraviteral injection of 4 mg of triamcinolone acetonide followed by PDT with verteprofin within two weeks and had a follow up of 6 months or longer. Based on fluorescein angiographic findings patients were categorized into three groups according to the lesion type: predominantly classic, minimal classic and occult CNV. We measured visual acuity and assessed baseline and 6 months greatest lesion dimension (GLD), side effects as well as retreatment rate.
60 patients were evaluated, 39 with predominantly classic, 6 with minimal classic and 14 with occult CNV. Median follow up was 9 months (range 6 to 16 months). The mean baseline visual acuity was almost 20/100 (mean logMAR = 0.7). At 6 months the mean visual acuity had slightly improved and was almost 20/63 (mean logMAR 0.6). Overall, in the predominantly classic group almost 37.1 % improved, 45.7% maintained stable vision, 17.2 % impaired. In the minimal classic group about 16.7 % improved, 66.6 % maintained stable vision and 16.7% impaired. Visual acuity improvement achieved only 21.4% of the occult group, 42.8 % maintained stable vision and 35.8% impaired. Overall, mean GLD increased from 2825 (SD 1668) µm to 3150 (SD 1727) µm. There was no statistically significant difference between GLD in eyes with predominantly classic CNV, minimally classic CNV or occult CNV. Eight patients of the predominantly classic group needed retreatment, 2 of the occult group and none of the minimal classic group. No severe systemic and ocular adverse events were encountered.
The number of patients in each group was limited; however, of our patients with subfoveal CNV secondary to AMD 76.7 % could maintain or improve their visual acuity 6 months after verteprofin PDT combined with iTAAC. Patients with predominantly classic or minimal classic component seem to benefit from combined PDT with I TAAC more than patients with occult CNV.
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