Purchase this article with an account.
A.K. Shah, N. Mandava, J. Olson; Three–Way Comparison of Photodynamic Therapy With and Without Adjunctive Subtenon's or Intravitreal Triamcinolone Acetonide in the Treatment of Choroidal Neovascularization Associated With Age–Related Macular Degeneration . Invest. Ophthalmol. Vis. Sci. 2006;47(13):362.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
To examine the 1, 3, & 6 month results of a group of patients treated with photodynamic therapy (PDT) used either alone, or in combination with either subtenon’s triamcinolone acetonide (STTA) or intravitreal triamcinolone acetonide (IVTA) in the treatment of choroidal neovascularization (CNV) secondary to age–related macular degeneration (ARMD).
Twenty–eight patients with CNV were treated with either PDT alone (twelve patients; PDT group/control), PDT with immediate subtenon's injection of triamcinolone acetonide (seven patients; STTA group), or PDT with immediate intravitreal injection of triamcinolone acetonide (nine patients; IVTA group). Visual acuity (VA) and mean intraocular pressures (IOP) as well as initial fluorescein angiography (FA) (obtained at the visit just prior to treatment) were recorded and subsequent VA, IOP, and FA from follow–up visits were examined and compared within and between the different groups at 1, 3, & 6 months post treatment.
Mean age of the patients was 78.6 +/– 10.1 years and the mean baseline VA was 20/276 (no difference in either variable was noted between the three groups). The Wilcoxon signed rank test was used to analyze changes of visual acuity within groups. In the PDT only group, there was no statistically significant change in mean VA at 1 month (P=0.46) or 3 months, (P=0.56), but at 6 months, there was a significant decline in vision to 20/1000 (P=0.04). In the STTA group, mean visual acuities were not significant at any time point: 1 month (P=0.16), 3 months (P=0.11) & 6 months (P=0.31). In the IVTA group, the VA change was not significant at the 1 month visit (P=0.25), but was statistically worse at both the 3 month (P=0.02) & 6 month visits (P=0.03). The non–parametric Kruskal–Wallis test was used to analyze changes between all three groups. There was no statistically significant difference between the groups at any time point: 1 month (P=0.31), 3 month (P=0.63) & 6 month (P=0.06). Finally, in terms of intraocular pressure, chi–square analysis did not reveal any statistical significance to the IOP rises observed post treatment (P=0.19).
No statistical significance could be demonstrated between the outcomes in the three groups examined in our retrospective study. Secondly, IOP elevation was not a significant factor in determining the course of therapy. A larger, randomized control trial with more patients and longer period of follow–up is warranted to evaluate efficacy of the different treatment regimens.
This PDF is available to Subscribers Only