Abstract
Purpose: :
To examine the therapeutic effects of posterior juxtascleral triamcinolone acetonide (TA) injection before photodynamic therapy (PDT) versus PDT alone for subfoveal choroidal neovascularization (CNV) secondary to age-related macular degeneration (AMD).
Methods: :
Group 1: 71 eyes from 69 patients with exudative AMD treated with PDT alone were included. The mean age was 73.0 years (range: 50 to 90 years).Group 2: 22 eyes from 22 patients with exudative AMD treated with PDT and 20mg of posterior juxtascleral triamcinolone acetonide were included. The mean age was 77.0 years (range: 68 to 83 years). Patients with CNV had been treated with the therapeutic effects of PDT were assessed by flourescein angiography, indocyanine green angiography, optical coherence tomography, and corrected visual acuity. The follow-up period was 12 months.
Results: :
All eyes maintained baseline visual acuity in both groups. In group 1, visual acuity was improved by 3 lines or over in 27 eyes (38%), did not change in 31 eyes (44%), decreased by 3 lines decrease or below in 13 eyes (18%). In group 2, visual acuity was improved by 3 lines or over in 5 eyes (23%), did not change in 13 eyes (59%), decreased by 3 lines decrease or below in 4 eyes (18%). The CNV occluded in 56 eyes (79%) of group1, 20 eyes (91%) of group 2. The mean number of treatments was 1.9 in group 1, 1.5 in group 2 (P<0.05 Mann-Whitney U test). The intraocular pressure rises could not be observed post treatment. No systemic complications were observed.
Conclusions: :
Combined PDT with posterior juxtascleral TA is effective for stabilization of visual acuity, and may be superior to PDT alone in patients with AMD.
Keywords: age-related macular degeneration • photodynamic therapy • corticosteroids