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U. Introini, M. Setaccioli, M. Gagliardi, A. Ramoni, F. Scotti, R. Brancato; Intravitreal Triamcinolone Acetonide (IVTA) Injection Alone or Combined With PDT for Vascularized Retinal Pigment Epithelial Detachments (V–PED) in AMD . Invest. Ophthalmol. Vis. Sci. 2006;47(13):4275.
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to assess the safety and the efficacy of Intravitreal Triamcinolone Acetonide Injection (IVTA) combined or not with PDT in the treatment of Vascularized PEDs in AMD over a short term.
prospective interventional noncomparative pilot case study. Thirty–three eyes of 33 consecutive patients affected by exudative AMD and vascularized serous PED (15 eyes with a RAP and 18 eyes with a CNV) were included. At baseline, each patient underwent a 4 mg Triamcinolone Acetonide intravitreal injection. Photodynamic Therapy with Verteporfin (PDT) was delivered two weeks after the IVTA. All patients had a complete ophthalmologic examination, fluorescein angiography (FA), indocyanine green angiography (ICGA), and optical coherence tomography (OCT3) at baseline and at each control visit. Follow–up visits where set at one, two, four weeks and then monthly for at least 3 months.
24 patients (12 with RAP and 12 with CNV) received the combined therapy (IVTA + PDT). 9 eyes received only the IVTA: 3 eyes with RAP had a resolution of the PED within two weeks, and 6 eyes with CNV where considered at high risk of RPE tear. In the RAP group, mean baseline VA was 0.23±0.17. VA decreased to 0.12±0.17 at month 6 (14 eyes) and to 0.08±0.04 at month 12. 13 eyes (87%) showed a PED thickness decrease. In the group with CNV, mean baseline VA was 0.36±0.17, and remained stable at month 6 and 12 (0.31±0.21, 16 eyes and 0.35±0.2, 8 eyes respectively).
in this pilot serie IVTA seems to be effective in stabilizing VA in eyes which present a PED associated with a CNV. When PED is associated with RAP, the anatomic effect of IVTA on the RPE elevation appears favourable, however VA is not positively influenced. IVTA efficacy in V–PED treating, although promising, deserves now to be assessed in a multicentric randomized trial.
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