Abstract
Abstract: :
Purpose: To evaluate the efficacy of sub–Tenon’s injections of triamcinolone acetonide as an adjuntive treatment to photodynamic therapy (PDT) with verteporfin for subfoveal choroidal neovascularization (CNV) in age–related macular degeneration (AMD). Methods: A retrospective, non randomized, study of 67 eyes of 67 patients with CNV related to AMD eligible for PDT according to TAP and VIP results. Posterior sub–tenon injection of triamcinolone (40 mg) was performed for 2 to 6 days before PDT. Safety, proportion of eyes that lost or gained >10 ETDRS letters, number of PDTs and side effects were assessed after 6 months follow–up. Two independent physicians evaluated the requirement of a new treatment at 3 and 6 months. Visual acuity maintained off 20/200, persistence of a sub–retinal fluid in the fundus and/or leakage on the fluorescein angiography indicated re–treatment. Results: At 3 months follow–up, 56 patients were available for evaluation. Mean visual acuity was unchanged. No statistical difference was observed between the components of CNV (classic vs occult), or the status of the patient (with prior PDT therapy vs no prior PDT therapy). 20 patients (34.5%) required a additional PDT. Only 1 patient demonstrated a transient intra–ocular pressure elevation. These results were confirmed at 6 months follow–up. Conclusions: Combined treatment with sub–Tenon’s triamcinolone and PDT with verteporphin appeared to be safe, maintaining visual acuity at 6 months. Moreover, the number of PDTs performed at 3 months were less than in the TAP and VIP studies. These results must be confirmed with longer follow–up. Optical Coherence Tomography could be useful to determine accurately the parameters of re–treatment.
Keywords: age-related macular degeneration • choroid: neovascularization • corticosteroids