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J.F. Arevalo, R.A. Garcia, A.J. Mendoza, C.F. Fernandez; Indocyanine Green–mediated Photothrombosis (IMP) With and Without Intravitreal Triamcinolone Acetonide for Subfoveal Choroidal Neovascularization in Age–related Macular Degeneration . Invest. Ophthalmol. Vis. Sci. 2005;46(13):291.
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Purpose:To determine if indocyanine green (ICG)–mediated photothrombosis (IMP) with and without intravitreal triamcinolone acetonide (TA) can improve the chance of stabilizing or improving vision in patients with subfoveal choroidal neovascularization (CNV) in age–related macular degeneration (AMD). Methods:Thirty–six patients (44 eyes) participated in the study. Thirty–one eyes of 26 patients were treated with IMP immediately followed by an intravitreal injection of 4 mg of TA (Group A), and 13 eyes of 10 patients were treated with IMP only (Group B). Patients had a mean follow–up of 6.5 months (range: 3 to 14 months). Patients underwent single or two sessions of IMP. Results: In Group A, visual acuity showed stability in 25 eyes (80.7%), and improvement of visual acuity (VA) in 5 eyes (16.1%), and worsening of visual acuity in 1 eye (3.2%). Group B presented VA stability in 10 eyes (76.9%), improvement in 1 eye (7.7%), and worsening of visual acuity in 2 eyes (15.3%) (p = 0.05). A significant regression of the CNV, and diminishing of subretinal fluid was demonstrated with fluorescein angiography and optical coherence tomography in both groups. We found no complications associated to the intravitreal injection procedure or IMP. Five (16.1%) eyes developed an increased in intraocular pressure (in Group A) related to the presence of TA in the vitreous cavity. However, it was medically controlled with topical anti–glaucoma medications. Conclusions: IMP with and without intravitreal TA may provide stability or improvement in visual acuity and fundus findings in exudative AMD. Further evaluation in a multicenter, randomized, placebo–controlled clinical trial with longer follow–up is needed to accurately assess the safety and efficacy of this new treatment modality.
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