Abstract
Purpose::
To investigate the efficacy and safety of posterior subtenon triamcinolone acetonide (PST) injection, both alone and in combination with photodynamic therapy, in the treatment of exudative AMD.
Methods::
Retrospective chart review of 13 patients (15 eyes) with exudative AMD who were treated with either PST (40 mg) alone (nine eyes) or in combination with PDT using verteporfin (six eyes). Efficacy of therapy was measured by following visual acuity (measured at six weeks to 13 months), serial optical coherence tomography (OCT), and necessity of re-treatment. Safety was followed by serial clinical examinations and intra-ocular pressure measurements for at least three months.
Results::
In the group treated with PST alone, OCT demonstrated decreased retinal thickening in 66.7% (6/9); visual acuity improved in 66.7% (6/9). In the group with combination therapy, 83.3% (5/6) of eyes had decreased retinal thickness on OCT and 66.7% (4/6) of eyes showed improvement in visual acuity. The majority of patients in both groups required retreatment at a mean of four months (range 6 weeks to 14 months): 77.8% (7/9) in the PST group and 83.3% (5/6) in the combination therapy group. One patient in the PST group had an elevation of intraocular pressure, which was managed by topical ocular hypotensive medication. Two patients who had a history of steroid response remained normotensive after treatment with PST.
Conclusions::
. Subtenon injection of triamcinolone may be an effective alternative treatment for exudative AMD. In many patients, an adequate clinical response may be achieved with improvement in retinal contour and visual acuity. It may be a safer alternative to intravitreal triamcinolone, either alone or in combination with PDT, especially for monocular patients or those with a history of steroid-induced glaucoma.
Keywords: age-related macular degeneration • choroid: neovascularization • injection