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A.J. Franklin, A.R. Easterling; Combined Photodynamic Therapy and Intravitreal Triamcinolone Acetonide in the Treatment of Neovascular Age–Related Macular Degeneration . Invest. Ophthalmol. Vis. Sci. 2005;46(13):324.
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Purpose: To determine the efficacy and safety of combined photodynamic therapy (PDT) and intravitreal triamcinolone acetonide in the treatment of neovascular age–related macular degeneration (AMD). Methods: Retrospective chart review of 32 consecutive patients treated with PDT and intravitreal triamcinolone acetonide for neovascular AMD. Results: The patients were followed for an average of 8 months. Of the 32 patients, 6 had previously received PDT (Group A) for neovascular AMD. These 6 patients all had a final visual acuity in the range of a 1 line gain to a 1 line loss on Snellen chart in comparison to their vision prior to combined therapy. Of the 26 patients with no prior PDT (Group B), 4 gained more than 3 lines of acuity, 1 patient gained 3 lines, 4 patients gained 2 lines, 15 patients remained stable (in the range of 1 line gain to 1 line loss), 2 patients loss 3 lines; and no patients loss more than 3 lines of acuity. Therefore, 5 patients (19.2%) in Group B had a visual acuity improvement of 3 or more lines, and 24 patients (92.3%) had stabilization or improvement in visual acuity. None of the patients in either group loss more than 3 lines of visual acuity. Three patients (50%) in Group A and 2 patients (7.7%) in Group B required retreatment with triamcinolone acetonide during the follow up period. Two of the 6 patients (33%) in Group A were placed on topical pressure lowering agents for elevated intraocular pressures (IOP). Two of the 26 patients (7.7%) in Group B were placed on pressure lowering agents. All 4 patients' intraocular pressures responded to topical therapy. Conclusions: Intravitreal triamcinolone acetonide in combination with photodynamic therapy appears to be an effective and safe treatment alternative for stabilizing or improving visual acuity in neovascular AMD. These results agree with a previous study by Spaide, et al.
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