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R. Dunavoelgyi, S. Sacu, G. Weigert, C. Pruente, U. Schmidt-Erfurth; Long-Term Results of Reduced Fluence versus Standard Fluence Photodynamic Therapy in Combination With Intravitreal Triamcinolone Acetonide. Invest. Ophthalmol. Vis. Sci. 2008;49(13):554. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
To compare the functional, morphological and angiographical effects of the combination therapy of reduced fluence PDT (rPDT; 300 mW/cm2) and IVTA with standard fluence PDT (sPDT; 600 mW/cm2) and IVTA in patients with choroidal neovascularisation (CNV) secondary to age-related macular degeneration.
Fourty patients were included in this prospective, comparative clinical trial and were randomized equally to one of the two groups. Visual acuity (VA) was measured using ETDRS charts at 2 meters. Central retinal thickness (CRT) was assessed using Stratus OCT (Zeiss), leakage activity of the CNV was evaluated using fluorescein angiography (FA). Macular sensitivity (MS) was measured using the MP-1 microperimeter (Nidek). Examinations were done at baseline, 3, 6, 9 and 12 months after initial treatment.
VA improved from 37.5±2.3 to 38.6±4.2 letters in the rPDT group (p=0.8), and decreased from 38.1±4.3 to 31.6±4.5 letters (p=0.21) in the sPDT group. The difference in visual acuity was not statistically significant. CRT decreased from 319.6±31.6 to 210.3±17.1µm (p=0.01) in the rPDT and from 315.4±23.1 to 267.6±25.2µm (p=0.20) in the sPDT group. The difference was not statistically significant. In FA, early phase leakage area increased from 3.7±0.3 to 4.0±0.3mm2 and from 2.8±0.3 to 3.7±0.3mm2, late phase leakage area increased from 4.1±0.3 to 4.3±0.2mm2 and from 3.5±0.3 to 4.1±0.3mm2 in the rPDT and sPDT group, respectively, without statistical significance between the two groups (p>0.05). Macular sensitivity decreased from 5.4±0.8 to 4.9±0.8dB (p=0.49) in the rPDT group and from 4.71±0.7 to 3.5±0.9dB (p=0.16) in the sPDT group, again without statistically significant differences between both groups (p>0.05). On average, patients in the rPDT received 1.68, patients in the sPDT group 1.71 treatments (p=0.94).
Although there were no significant differences between the two groups, overall results showed a trend that PDT with reduced fluence is superior to PDT with standard fluence when combined with IVTA.
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