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A. Aue, C. Simader, J. Wagner, C. Kiss, R. Michels, S. Sacu, S. Michels, U. Schmidt–Erfurth; Characteristic Findings in Stratus OCT in Patients With Predominantly Occult Choroidal Neovascularization (CNV) in Age–Related Macular Degeneration Treated With Verteporfin Therapy and Intravitreal Triamcinolone . Invest. Ophthalmol. Vis. Sci. 2005;46(13):315.
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Purpose: To investigate characteristic early changes documented by Stratus OCT and fluorescein angiography in patients with predominantly occult CNV in age–related macular degeneration (AMD) which receive combination therapy. An intensive exudative response was described earlier following verteporfin monotherapy. Methods: Out of 35 consecutive patients with neovascular AMD treated with combination of verteporfin therapy and intravitreal triamcinolone demonstrating predominantly occult CNV were evaluated pre treatment, within 2 days of treatment, at one week and at 8 to 12 weeks follow–up. Standard verteporfin therapy was combined with an intravitreal injection of 4 mg triamcinolone within 6 hours following PDT. Treatment outcomes were evaluated using visual acuity, Stratus OCT, and fluorescein angiography. Results: Up to 2 days following treatment, only a moderate increase in subretinal fluid was documented by OCT, massive exudation as described after PDT monotherapy was not seen in any eye. One week following therapy, more than 90% of patients showed no indication for lesion activity as evaluated by OCT and fluorescein angiography. Visual acuity remained stable within one week of follow–up. Compared to baseline the majority of eyes demonstrated reduced intraretinal, subretinal and sub retinal pigment epithelium fluid at 12 weeks as shown by OCT as well as less leakage in fluorescein angiography. Mean visual acuity remained stable at baseline. Conclusions: Same day combination of standard verteporfin therapy and 4 mg intravitreal triamcinolone showed only a moderate therapy–induced exudative response, which was less that the extravasation observed after monotherapy. An effective CNV closure as well as stable visual acuity was achieved in patients with predominantly occult CNV.
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