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L. El Matri, K. Baklouti, F. Mghaieth, O. Charfi Ben Ammar, S. Ben Rejeb, R. Baccouri, M. Bukta; Photodynamic Therapy And Intravitreal Triamcinolone For Exsudative Age Related Macular Degeneration . Invest. Ophthalmol. Vis. Sci. 2004;45(13):3162.
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Purpose: To evaluate the effect of intravitreal triamcinolone acetonide on the outcome of patients with exsudative age related macular degeneration (AMD) before or after they are treated by photodynamic therapy (PTD). Methods: The prospective study included 34 eyes of 32 patients with neovascular AMD who received intravitreal triamcinolone acetonide (4 mg). Mean follow up time was 8.4 months (range: 3 to 18 months). Patients were divided into 3 groups: – group I: 15 patients (16 eyes) ineligibles for PDT – group II: 10 patients planned for PDT but waiting for healthcare insurance coverage – group III: 7 patients (8 eyes) have already been treated by PDT but they evolved to enlargement of neovascular membrane and visual loss Results: Visual acuity increased in 65% of cases, from CF – 0.05 up to 0.05 – 0.2. – group I: visual acuity having improved to 0.16 in 7 cases after 1 to 3 months, PDT was performed and led to stabilization of lesions. – group II: visual acuity increased in 3 cases and remained stable in 5 cases without neovascular membrane extension, thus PDT was indicated 1 to 4 months after the diagnosis. – group III: visual acuity was stabilized with reduction of subretinal fluid exsudation and no extension of neovascular membrane. Intravitreal triamcinolone acetonide was repeated within 4 months in 5 cases. Intraocular pressure increased temporarily in 1 case. Two patients developed acute endophtalmitis 2 days after intravitreal injection. It resolved without vitrectomy and cleared with systemic antibiotics and local steroids and antibiotics treatment after 10 and 14 days. Increasing in the degree of cataract was noted in the majority of cases. No cases of retinal detachment or proliferative retinopathy occurred. Conclusions: Intravitreal triamcinolone acetonide may be considered as a complementary treatment to PDT in some cases of exsudative AMD.
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