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X. Zhang, L. Xu, D. Wang, J. Jonas; Low Power Transpupillary Therapy Combined with Intravitreal Injection of Tramcinolone Acetonide for Occult Choriodal Neovascularization . Invest. Ophthalmol. Vis. Sci. 2006;47(13):2162.
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© ARVO (1962-2015); The Authors (2016-present)
To examine the 3–month to 1 year results of a group of patients treated with combined transpupillary therapy (TTT) and intravitreal triamcinolone for occult sub–retinal neovascularization(CNV) secondary to age–related macular degeneration(AMD)
11 eyes of 11 AMD patients with occult or minimally classic (< 10%) neovascularization membranes determined by FFA and OCT with a diameter less than 4500 mm were treated with TTT, followed by an intravitreal injection of 10mg of crystalline triamcinolone acetonide. Visual acuity was measured by early treatment diabetic retinopathy study protocol refraction, need for re–treatment was based on fluorescein angiographic evidence of leakage at 3– month follow–up intervals. Macular thickness was evaluated by OCT and recorded as the standard nine quadrants in the macular thickness map .
Macular thickness was reduced in the 11 patients at the end of the 1stmonth , 3th month and maintained at the end of the follow up period. The average reduced macular thickness of the nine quadrants is 44.5± 2.2 µm at the end of 3 month follow up. There is a statistical significance of the macular thickness between pre–treatment and post– treatment. (paired t–test, p<0.05). 2 of the 11 eyes(18.2%) the mean visual acuity change at 3 months was an improvement of 3 lines, and 1(9%) had an improvement of 2 lines. 9 eyes(72.8%) kept their VA stable. 2 eyes (18.2%) required TTT re–treatment at 3 months. At the 6–month follow–up, available for 11 eyes the mean visual acuity change from baseline was an improvement of 2.4 lines, 3 (27.3%) eyes had an improvement of at least 3 lines and 1 eye (9%) required re–treatment. No patient at any time point experienced a loss of visual acuity of 3 or more lines.1 patient (9%) required monodrop therapy to control the intraocular pressure. No eye developed endophthalmitis and cataract at the end of the follow up.
Although the number of patients in this pilot study was limited, the improvement of acuity, the reduced macular thickness and treatment frequency in these patients suggest that combination therapy with TTT and intravitreal triamcinolone acetonide may benefit for those patients with occult sub–retinal neovascularization . Elevated IOP seems to be the most frequent early side effect of the treatment.
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