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R. Schadlu, R.S. Apte; Treatment of Exudative Age–Related Macular Degeneration With PDT and Intravitreal Injection of Triamcinolone Acetate . Invest. Ophthalmol. Vis. Sci. 2005;46(13):313.
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Purpose: To evaluate the effect of combined intravitreal steroid injection with photodynamic therapy (PDT) in patients with exudative age–related macular degeneration (AMD). Methods: 10 eyes of 9 patients with exdative AMD were treated with PDT combined with 4mg of triamcinolone acetate injected intravitreally. Fluorescein angiography allowed classification of six of the choroidal neovascular membranes as occult, the remaining 4 as predominantly classic. Visual data from these eyes was extracted retrospectively via chart review. Results: The median pretreatment LogMAR visual acuity was 1.09 (Snellen equivalent of 20/250). Median follow–up was 11 months and median treatment was one intravitreal injection and one PDT session. Final LogMAR visual acuity was calculated as a median of 1.30 (Snellen equivalent of 20/400). 4 eyes experienced decreased central acuity at the end of the observation period (median decrease of 0.42 LogMAR units). 3 eyes maintained their visual acuity. The remaining 3 eyes experienced an increase in central visual acuity (median improvement of 0.18 LogMAR units). Conclusions: Combined use of intravitreal triamcinolone and photodynamic therapy may prove cost–effective and treatment–sparing in eyes with exudative AMD that are unresponsive to photodynamic therapy alone. Further studies and careful patient selection may optimize the amount of visual rehabilitation or preservation.
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