May 2007
Volume 48, Issue 13
Free
ARVO Annual Meeting Abstract  |   May 2007
Randomized, Double Blind, Controlled Study With Verteporfin Photodynamic Therapy and Intravitreal Triamcinolone(IVTA) vs Triple Theraphy With Verteporfin Photodynamic Therapy, Intravitreal Triamcinolone and Intravitreal Ranibizumab in Patients With Subfoveal Choroidal Neovascularization(CNV) Secondary to Age-Related Macular Degeneration(AMD)
Author Affiliations & Notes
  • R. M. Romero
    Retina, Asoc para Evitar la Ceguera, Mexico DF, Mexico
    Retina, Centro médico ISSEMYM, Metepec, Mexico
  • G. Monares
    Retina, Centro médico ISSEMYM, Metepec, Mexico
  • J. C. De la Luz
    Retina, Centro médico ISSEMYM, Metepec, Mexico
  • A. Morales
    Retina, Centro médico ISSEMYM, Metepec, Mexico
  • G. Padilla
    Retina, Centro médico ISSEMYM, Metepec, Mexico
  • A. Niño-Pecina
    Retina, Centro médico ISSEMYM, Metepec, Mexico
  • H. Quiroz-Mercado
    Retina, Asoc para Evitar la Ceguera, Mexico DF, Mexico
  • Footnotes
    Commercial Relationships R.M. Romero, None; G. Monares, None; J.C. De la Luz, None; A. Morales, None; G. Padilla, None; A. Niño-Pecina, None; H. Quiroz-Mercado, None.
  • Footnotes
    Support None.
Investigative Ophthalmology & Visual Science May 2007, Vol.48, 72. doi:
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      R. M. Romero, G. Monares, J. C. De la Luz, A. Morales, G. Padilla, A. Niño-Pecina, H. Quiroz-Mercado; Randomized, Double Blind, Controlled Study With Verteporfin Photodynamic Therapy and Intravitreal Triamcinolone(IVTA) vs Triple Theraphy With Verteporfin Photodynamic Therapy, Intravitreal Triamcinolone and Intravitreal Ranibizumab in Patients With Subfoveal Choroidal Neovascularization(CNV) Secondary to Age-Related Macular Degeneration(AMD). Invest. Ophthalmol. Vis. Sci. 2007;48(13):72.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose:: To compare the efficacy of photodynamic therapy with verteporfin (PDT) and IVTA vs triple therapy (TT) in patients with subfoveal choroidal neovascularization (CNV) secondary to age-related macular degeneration (AMD).

Methods:: Prospective, comparative, randomized, double blind, controlled study. 15 patients with classic subfoveal choroidal neovascularization secondary to age-related macular degeneration were randomized. Group 1: receive PDT followed by 4 mg IVTA (n=7) or group 2: TT (triple Therapy) PDT followed by 4 mg IVTA + 0.5 mg Ranibizumab (n=8).The main outcome measures were visual acuity (VA), mean change in lesion size, mean change in foveal thickness, retreatment rate and the incidence and severity of adverse events.

Results:: At 6 months 5 of 7 patients (71.4%) of group 1 and 8 of 8 patients (100% ) of group 2 had lost fewer than 15 letters (P<.001). Three patients (37.5%) of group 2 had an improvement of 3 lines or more. Lesion type, patient age, and lesion size had no influence on the outcome, but baseline VA had a statistically significant effect (P =.006). The median number of treatments in both groups was one. The 28% of PDT-triamcinolone group and 25% of triple therapy group had an increase in intraocular pressure (IOP) that required therapy. Progression or development of cataract was observed in 14.2 % in PDT- IVTA group and 12.5% in Triple therapy group. There were no cases of endophthalmitis. No cardiac or cerebrovascular accidents where presented.

Conclusions:: The combination of PDT, intravitreal triamcinolone acetonide and intravitreal ranibizumab is a safe treatment option for neovascular AMD and prevents a considerable decrease in VA. In our patients it seems to be superior than combined therapy with PDT and triamcinolone.Clinical Relevance: Triple therapy can potentially offer a new treatment modality for choroidal neovascularization in patients with macular degeneration and other diseases.

Clinical Trial:: www.clinicaltrials.gov APEC-0031

Keywords: choroid: neovascularization • photodynamic therapy • imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound) 
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