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R.F. Spaide, J. Sorenson; Combined Photodynamic Therapy with Verteporfin and Intravitreal Triamcinolone Acetonide for Choroidal Neovascularization . Invest. Ophthalmol. Vis. Sci. 2003;44(13):5032.
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Purpose:To examine combined photodynamic therapy (PDT) with verteporfin and intravitreal triamcinolone acetonide for choroidal neovascularization (CNV) secondary to age-related macular degeneration (AMD). Methods:The patients with CNV were treated with PDT immediately followed by an intravitreal injection of 4 mg of triamcinolone acetonide. Need for retreatment was based on fluorescein angiographic evidence of leakage at 3 month follow-up intervals. Thirteen with CNV, without restriction to type, were not treated with prior photodynamic therapy and were called the Newly Treated group. Thirteen patients with prior PDT therapy who experienced visual loss while being treated with PDT alone comprised the remainder and were termed the Prior PDT group. Results:Of the eyes of 13 patients in the Newly Treated group the mean visual acuity change at 3 months was an improvement of 1.9 lines (p=0.023, Wilcoxon signed ranks test as compared with baseline) and 4 (30.8%) had an improvement of at least 3 lines. Two patients (15.4%) required retreatment at 3 months. Among the 13 eyes of 13 patients in the Prior PDT group, the mean change in visual acuity from baseline at the 3 month follow-up was 0.31 lines. No patient in the Prior PDT group required retreatment at 3 months. No patient in either group at any time point experienced a loss visual acuity of 3 or more lines. Five patients (19.2%), 3 in the Newly Treated group and 2 in the Prior PDT group, required monodrop therapy to control their intraocular pressure. No patient developed endophthalmitis. Conclusions:Although the number of patients in this pilot study was limited, the improvement of acuity and the lack of fluorescein leakage in these patients suggest combination therapy with PDT and intravitreal triamcinolone acetonide merits further investigation, particularly as first line therapy.
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