Abstract
Purpose: :
To evaluate visual acuity (VA) outcomes from patients underwent combination therapy with photodynamic therapy (PDT) and intravitreal triamcinolone acetonide (IVTA) to treat choroidal neovascular membranes (CNV) in age-related macular degeneration (AMD) at the 2 years follow-up.
Methods: :
A retrospective, comparative, consecutive and interventional case series included 32 eyes of 30 patients of CNV due to AMD were treated with PDT with verteporfin followed by an injection of 4 mg IVTA, at the São Paulo University, Brazil, between October 2003 and February 2005. Twenty-one eyes were naïve to treatment (group I) and 11 had been treated previously by PDT alone (group II). Inclusion criteria included CNV of any angiographic subtype and size.The main outcome measures were pre and post-treatment changes in the best-corrected VA (by ETDRS charts) and influence of lesion size in the results. All patients were submitted a complete examination before and 6, 12 and 24 months after procedure.
Results: :
The mean age was 77 ±8 (group I) and 76 ±10 (group II). There were 20 males (55,56 %) and 16 women (44,44%) in group I and 7 males (19,44%) and 9 women(25%) in group II. The lesion size was 2556 ±1357 (group I) and 3075 ±1485 (group II) and there was no statistically difference in lesion size between both groups. At the 2-year follow-up VA was significantly better in group I patients who received combined therapy at the 6 (p=0,028) and 12 (p=0,013) months after treatment. After 2-year complete follow-up in group I: 8 patients (36,36 %) had improve in VA, 4 (18,18%) stabilized vision and 10 had decrease in VA; in group II: 3 patients (27,27%) had improve in VA, 3 (27,27%) stabilized vision and 5 (45,45%) had decrease in VA.
Conclusions: :
Combined therapy seemed to be more effective to improve VA and stabilizes vision during two years follow-up and the results are better when the patients are naive.
Keywords: age-related macular degeneration • choroid: neovascularization • photodynamic therapy