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D. Tsuchiya, T. Yamamoto, H. Yamashita; Combined Therapy of Photodynamic Therapy With Verteporfin and Juxtascleral Injection of Triamcinolone Acetonide for Age-Related Macular Degeneration. Invest. Ophthalmol. Vis. Sci. 2007;48(13):4547.
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To investigate the therapeutic effects of combined therapy of photodynamic therapy (PDT) with verteporfin and posterior juxtascleral injection of triamcinolone acetonide (TA) for subfoveal choroidal neovascularization (CNV) caused by age-related macular degeneration (AMD).
Twenty-four eyes of 24 cases of AMD with CNV were included. The mean age was 75.5 years (range: 66 to 84 years) and the mean follow-up period was 5.3 months (3 to 9 months). The findings of CNV were as follows: the predominantly classic in 2 eyes (8.3%), the minimally classic in 4 eyes (16.7%), and the occult with no classic in 18 eyes (75.0%). Patients with CNV had been treated with PDT and the posterior juxtascleral injection of 40mg of triamcinolone acetonide. The therapeutic effects were assessed by flourescein angiography (FA), indocyanine green angiography (IA), optical coherence tomography, and corrected visual acuity.
Visual acuity was improved by 3 lines or over in 6 eyes (25.0%), did not change in 16 eyes (66.7%), decreased by 3 lines decrease or below in 2 eyes (8.3%). It was better than the result of PDT alone that visual acuity was improved by 2 lines or over in 10.0%, did not change in 82.2%, decreased by 2 lines decrease or below in 8.8%. The original regions of the CNV were occluded in 18 eyes (75.0%).The retinal thickness was decreased in 17 eyes (68.0%). The subretinal hemorrhage was detected in 3 eyes after PDT. Intraocular pressure increase or systemic complications were not observed. Each eye received average 1.2 treatments (range: 1 to 2 times).
Combined therapy of PDT and juxtascleral TA is effective for stabilization of visual acuity, and may be superior to PDT alone in patients with AMD.
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