December 2002
Volume 43, Issue 13
Free
ARVO Annual Meeting Abstract  |   December 2002
Feeder Vessel (FV) Treatment of Choroidal Neovascularization (CNV) With Sub-Tenon’s Corticosteroid Injection as Adjuvant Therapy
Author Affiliations & Notes
  • RE Tuller
    Chevy Chase/Towson MD
  • BM Glaser
    Chevy Chase/Towson MD
  • JK Luu
    Chevy Chase/Towson MD
  • Footnotes
    Commercial Relationships   R.E. Tuller, None; B.M. Glaser, None; J.K. Luu, None.
Investigative Ophthalmology & Visual Science December 2002, Vol.43, 2513. doi:
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      RE Tuller, BM Glaser, JK Luu; Feeder Vessel (FV) Treatment of Choroidal Neovascularization (CNV) With Sub-Tenon’s Corticosteroid Injection as Adjuvant Therapy . Invest. Ophthalmol. Vis. Sci. 2002;43(13):2513.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Abstract: : Purpose: To report on the effects of feeder vessel treatment of choroidal neovascularization in conjunction with the use of sub-Tenon's corticosteroid injection as adjuvant therapy. Methods: The charts of 7 patients (7 eyes) who underwent feeder vessel treatment and received sub-Tenon's corticosteroid injection for choroidal neovascularization were studied. Patients evaluated in this retrospective chart review were treated with sub-Tenon's corticosteroid injection(s) after receiving multiple feeder vessel laser treatments for recurrent or persistent CNV with subretinal fluid (SRF). End point of treatment was regression of CNV and resolution of SRF as noted by clinical exam, fluorescein and high-speed ICG angiography. Two retina specialists performed the clinical exam and angiographic interpretation. Feeder vessel laser treatment was performed using an 810 nm laser, set at a 75 micron spot size, pulse duration of 100 milliseconds, 50% duty cycle (millipulse mode), for an average total duration of 400 to 800 spots. The sub-Tenon's corticosteroid injection consisted of 0.5cc of dexamethasone 4mg/ml and 0.5cc of triamcinolone 40mg/ml with a 1ml TB syringe and 25g needle. Proparacaine HCl 0.5% was used for topical anesthesia. Results: In the 7 patients, multiple FV treatments had been applied before considering sub-Tenon's steroids. Patients in this group had received a mean of 10.4 laser treatments (range 3 - 14) without regression of CNV and resolution of SRF. However, in all 7 cases, the subsequent combination of sub-Tenon's steroids with FV treatment resulted in ensuing regression of CNV and resolution of SRF requiring only a mean of 2.7 additional FV treatments (range 1 - 6). Conclusions: In these patients, a trend was noted towards enhanced regression of CNV and resolution of SRF with the addition of corticosteroid sub-Tenon's injection to FV treatment. Corticosteroids have an antiangiogenic capacity that may prove useful in the treatment of CNV. The role of sub-Tenon's or even intravitreal corticosteroids as an adjunct to treatments for CNV warrants further study.

Keywords: 308 age-related macular degeneration • 346 choroid: neovascularization • 377 corticosteroids 
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