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L. El Matri, F. Kort, A. Chebil, N. Ben Youssef, K. Baklouti; Intravitreal Injection of Triamcinolone Combined With Bevacizumab for Choroidal Neovascularization Associated With Large Retinal Pigment Epithelial Detachment in Age Related Macular Degeneration. Invest. Ophthalmol. Vis. Sci. 2009;50(13):1917.
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To discuss the effect and outcome of a combined intravitreal triamcinolone acetonide (IVTA) injection with intravitreal bevacizumab (IVB) in treating choroidal neovascularization (CNV) associated with large retinal pigment epithelial detachment (PED) in age-related macular degeneration (AMD).
Seven eyes (5 patients) with CNV associated with large PED in AMD were treated by IVTA (4 mg/ 0.1 ml) followed by IVB (1.25 mg/0.05 ml) one week later. Patients were evaluated for best corrected visual acuity (BCVA) and optical coherence tomography (OCT) at baseline, one week and every 6 weeks. Fluorescein angiography (FA) and ICG were performed at baseline and at month three. Indications for retreatment by combined injection was defined as persistent PED with subretinal and/or intraretinal fluid on OCT. Patients with flattening of the PED and persistent activity leakage demonstrated by OCT underwent subsequent IVB.
The mean duration of follow up was 9 months (6 to 16 months). BCVA at baseline averaged 20/63 (range 20/200 to 20/32) and 20/58 (range 20/125 to 20/25) at the end of follow-up. Average central foveal thickness (CFT) was 353.5 microns (range 265 to 405) at baseline and 205.1 microns (range 174 to 261) at the end. The number of reinjection was 4 for combined treatment and 3 for IVB alone. Leakage from CNV decreased in all eyes at month three. We observed in all patients a slight flattening of the DEP at 2 months with a recurrence at a mean time of 4 months in 3 eyes. No RPE tear appeared during follow-up. Two eyes developed glaucoma controlled by topical medication. There were no other ocular or systemic complications.
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