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K.H. Wu, G. Wang, N. Berker, M.S. Blumenkranz, S. Sanislo; Comparison of Intravitreal Triamcinolone With Photodynamic Therapy and Photodynamic Therapy Alone for Choroidal Neovascularization Secondary to Age–Related Macular Degeneration . Invest. Ophthalmol. Vis. Sci. 2006;47(13):359.
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© ARVO (1962-2015); The Authors (2016-present)
Combination photodynamic therapy with verteporfin and intravitreal triamcinolone (PDT–IVTA) has been shown to be effective in patients with choroidal neovascularization due to age–related macular degeneration (AMD). This study compares the visual and angiographic outcomes of PDT–IVTA with PDT alone.
We retrospectively reviewed the records of all AMD patients who underwent PDT–IVTA or PDT alone for choroidal neovascularization at the Stanford University Medical Center between December 2002 and June 2004 for a follow–up period of 12 months. Fluorescein angiograms were reviewed and graded by a single masked examiner. Outcome measures assessed included visual acuity, angiographic evidence of leakage, retreatment rate and complications.
Sixty–six eyes of 66 patients who received PDT–IVTA and 73 eyes of 70 patients who received PDT alone were included. The PDT–IVTA group had a better mean visual acuity at baseline compared with the PDT group (0.91±;0.50 logMAR vs 1.11±;0.52 logMAR, p=0.02). No other significant differences in baseline characteristics were noted. The results showed no significant differences in the mean visual acuity change from baseline at 3, 6 or 12 months between the 2 groups. Mean changes in visual acuity were an improvement of 0.03±;0.35 logMAR in the PDT–IVTA group versus a loss of 0.10±;0.50 logMAR in the PDT group at 3 months (p=0.08); and a loss of 0.08±;0.46 logMAR in the PDT–IVTA group versus a loss of 0.22±;0.56 logMAR in the PDT group at 12 months (p=0.16). At 3 months 46% of PDT–IVTA and 23% of PDT treated eyes demonstrated no leakage angiographically. The mean number of retreatments at 12 months was 0.56±;0.83 vs 0.58±;0.78 (p= 0.58) in the PDT–IVTA and PDT groups respectively. Complications included elevated intraocular pressure in 20% of PDT–IVTA treated eyes requiring 1.3±;0.6 medications, and increased cataract progression in 3% vs 0% of PDT–IVTA and PDT treated eyes respectively.
Mean change in visual acuity was better for eyes treated with PDT–IVTA versus PDT alone at both 3 and 12 months, although this was not statistically significant. Three month angiographic results were better in eyes treated with PDT–IVTA versus PDT alone. Combination PDT–IVTA therapy may be superior to PDT alone in patients with neovascular AMD, though it is also associated with a greater rise in intraocular pressure.
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