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D. Tsuchiya, T. Yamamoto, K. Saito, H. Yamashita; Comparison of Photodynamic Therapy With Verteporfin Combined With Posterior Juxtascleral Triamcinolone Acetonide and Photodynamic Therapy Alone for Age-Related Macular Degeneration. Invest. Ophthalmol. Vis. Sci. 2008;49(13):270.
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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).
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.
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.
Combined PDT with posterior juxtascleral TA is effective for stabilization of visual acuity, and may be superior to PDT alone in patients with AMD.
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