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MC Gillies, W Chua, P Mitchell, F Billson, A Hunyor, P Penfold, J Simpson; Photographic And Fluorescein Angiographic Outcomes From The Intravitreal Triamcinolone Study For Neovascular Armd . Invest. Ophthalmol. Vis. Sci. 2002;43(13):2907.
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Purpose:To assess the photographic and fluorescein angiographic changes in patients with exudative age-related macular degeneration treated with a single injection of intravitreal triamcinolone 4mg. Methods:The Intravitreal Triamcinolone Study is a prospective, single centred, double-blind, placebo-controlled, randomised clinical trial. Fundus photographs and angiograms taken at baseline, 3 months (FA), 6 months (photos), and 12 months were graded in a masked fashion according to a standardised protocol. Specific parameters graded on photographs included neurosensory detachment, RPE detachment, retinal haemorrhage, hard exudates, subretinal fibrosis, geographic atrophy, and presence of triamcinolone crystals. Features graded on angiograms included CNV type (classic/occult), CNV location (sub/juxta/extrafoveal), CNV size, and fluorescein leakage. Results:151 eyes of 139 patients were enrolled in the study. Baseline CNV characteristics were similar between the treatment and placebo groups. At 3 months, in the treatment group, CNV size had increased in 28 eyes (37%), remained unchanged in 19 (25%), and decreased in 6 (8%). This compares with 35 (46%) increased, 14 (18%) unchanged, and 0 decreased in the placebo group (P=0.008). A significant difference in favour of the treatment group was also found in the size of the neurosensory detachment at 6 months. No difference was found between the two groups with respect to any of the other parameters. Conclusion:Intravitreal triamcinolone appears to inhibit the growth of CNV and reduces subretinal fluid in the short term. Whilst this does not support its use as a sole agent in the treatment of classic CNV, it suggests that intravitreal triamcinolone should be investigated for more refined indications, for example for less advanced forms of the disease or in conjunction with other treatment.
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