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R.L. Ufret, D. Williams, P.K. Kaiser; OCT and Angiographic Analysis of Neovascular AMD Treated With PDT in Combination With Intravitreal Triamcinolone Acetonide vs. PDT Alone . Invest. Ophthalmol. Vis. Sci. 2005;46(13):316.
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Purpose: To examine the anatomic and angiographic effect of intravitreal triamcinolone acetonide in combination with photodynamic therapy (PDT) with verteporfin (compared to PDT alone) on eyes with neovascular age–related macular degeneration. Methods: Prospective comparative study of thirty–five eyes of thirty consecutive patients with choroidal neovascular membranes from AMD. Patients were evaluated with OCT, fluorescein angiography and clinical exam before and 3 months after their first treatment. The treatment consisted on either PDT followed immediately by an intravitreal injection of triamcinolone acetonide at a dose of 4 mg in 0.1 ml or PDT alone. The parameters measured on OCT included maximal thickness of any subretinal fluid (SRF) collection, pigment epithelial detachment when present, central macular thickness, maximal macular thickness, presumed–CNV thickness and total lesion thickness. Results: Treatment with a combination of PDT and triamcinolone acetonide resulted in a 93% reduction of subretinal fluid accumulation with complete resolution of SRF in 80% of cases. There was also a 19% reduction in foveal thickness, a 20% reduction in maximal macular thickness and a 22% decrease in total lesion thickness. The response of the CNV thickness was more variable. These results will be compared with similar measurements in patients receiving PDT alone. Correlation with the pre–treatment and post–treatment angiographic patterns. Visual acuity data will also be presented. Conclusions: PDT combined with triamcinolone acetonide seems to result in a more pronounced reduction in subretinal and intraretinal fluid accumulation and a better restoration of the macular contour in patients with neovascular AMD when compared to PDT alone. This correlates with less angiographic leakage and a decreased frequency of retreatment. Although a larger number of patients needs to be evaluated with a more prolonged follow up, our data supports the adjunctive use of intravitreal triamcinolone acetonide with PDT for the treatment of neovascular AMD.
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