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J. Arevalo, J.G. Sanchez, R.A. Garcia, L. Wu, M.H. Berrocal, F.J. Rodriguez, A. Rodriguez; Indocyanine Green–Mediated Photothrombosis (IMP) With Intravitreal Triamcinolone Acetonide for Macular Edema Secondary to Group 2A Idiopathic Parafoveal Telangiectasis Without Choroidal Neovascularization: A Pilot Study . Invest. Ophthalmol. Vis. Sci. 2006;47(13):5193.
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To determine the feasibility, safety, and clinical effect of IMP combined with intravitreal triamcinolone acetonide (IVTA) in patients with macular edema secondary to idiopathic parafoveal telangiectasis (IPFT) group 2A without choroidal neovascularization (CNV).
Nine eyes of 6 patients that were treated with IMP immediately followed by an intravitreal injection of 4 mg of TA participated in the study. Patients had a mean follow up of 22.6 months (range: 13 to 32 months). Patients underwent single to two sessions of IMP combined with IVTA. An IVTA without IMP group of 19 eyes from 14 patients with macular edema secondary to IPFT group 2A that had undergone an IVTA 4 mg without IMP was included for comparison. In addition, a control group of 34 eyes from 17 patients with macular edema secondary to IPFT group 2A without therapy was included.
Visual acuity (VA) showed stability in 5 eyes (55.5%), and improvement of VA (≥ 2 ETDRS lines) in 4 eyes (44.4%). A significant decrease of hyperfluorescence was not demonstrated with fluorescein angiography, however optical coherence tomography showed a decrease in the size of inner intraretinal hyporeflective spaces or cystic edema. We found no complications associated to the intravitreal injection procedure or IMP. Two (22.2%) eyes developed an increased in intraocular pressure related to the presence of TA in the vitreous cavity (controlled with topical medications). Cataract developed in 5 eyes (55.5%), and one of them required phacoemulsification and intraocular lens implantation. Six of 9 eyes (66.6%) required one retreatment during the study period. At the last follow up (mean: 17.3 months; range: 5–32 months) in the IVTA without IMP group, 5 (26.3%) improved VA (≥ 2 ETDRS lines), 11 (57.9%) remained within 2 lines of baseline VA, and 3 (15.8%) lost VA (≥ 2 ETDRS lines). In our control group with comparable follow up, all eyes showed deterioration of VA overtime.
Combined IMP and IVTA may provide stability or improvement in visual acuity and fundus findings in macular edema secondary to IPFT group 2A without CNV. In addition, combined IMP and IVTA seem to be better than IVTA alone or natural history in these cases.
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