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J. van Calster, A. Leys; Intravitreal Triamcinolone Acetonide Improves the Efficacy of Verteporfin in the Management of CNV Due to AMD With Retinochoroidal Anastomosis (RCA)/Retinal Angiomatous Proliferation (RAP) . Invest. Ophthalmol. Vis. Sci. 2005;46(13):322.
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Purpose: To investigate the safety and efficacy of photodynamic therapy (PDT) with verteporfin (Visudyne, Novartis Pharma AG) combined with intravitreal injection of triamcinolone acetonide in patients with CNV due to AMD and retinochoroidal anastomosis (RCA)/retinal angiomatous proliferation (RAP) in a 12–month pilot study. Methods: Patients with AMD and evidence of CNV leakage complicated with RCA/RAP and including macular edema and pigmentepithelium detachment were enrolled. Each patient received combination treatment at 3–month intervals if CNV leakage was evident. Patients received standard verteporfin PDT (6 mg/m2) and intravitreal injection (4 mg, 0.1 mL) of triamcinolone acetonide. We monitored near and far visual acuity (using the Snellen chart); retinal thickness (foveal and maximal using optical coherence tomography); and intra–ocular pressure (for possible increase). Results: All 23 patients (mean age 76.5 years) completed 3 months of follow–up; 74% (17/23) completed 6 months; and 39% (9/23) completed 12 months. Patients received an average of 1.32 and 1.64 treatments at 6 months and 12 months, respectively. Baseline VA was 0.19±0.09. VA increased after treatment by the 3–months visit (0.28±0.18), declining again by the 6–months visit (0.23±0.14). After treatment, VA improved again (0.29±0.14) by the 12–month visit. These visual outcome results as well as those for anatomical outcomes will be discussed together with the possible indications and limits of this technique. Conclusions: The study results demonstrate that through use of a combined treatment of vertoporfin PDT and intravitreal injection of triamcinolone acetonide 4 mg, stabilization and improvement of visual acuity and a decrease of retinal thickness could be achieved. The treatment combination proved to be safe in sterile conditions.
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