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P.K. Kaiser, D.S. Boyer, R.A. Mittra, R.B. Feldman, S. Dev, R.W. Reidy; Verteporfin Photodynamic Therapy and Intravitreal Triamcinolone Acetate for CNV due to AMD: Results From the Visudyne Patient Registry Database . Invest. Ophthalmol. Vis. Sci. 2005;46(13):3568.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: To examine the visual outcomes of patients receiving verteporfin (Visudyne, Novartis Pharma AG) photodynamic therapy (PDT) with adjunctive intravitreal triamcinolone acetate for the treatment of CNV due to AMD, using data from the Visudyne Patient Registry, an Internet–based, secure database. Methods: Retrospective analysis of patients treated for CNV due to AMD with verteporfin PDT and at least 1 adjunctive intravitreal injection of triamcinolone acetate. Triamcinolone was administered before, on the same day, or several days after verteporfin PDT. Snellen visual acuity and potential complications including intraocular pressure elevations, cataract, endophthalmitis/pseudoendophthalmitis, and retinal tears/detachments were recorded at each visit. Results: 335 patients with CNV due to AMD were enrolled by 6 physicians at 5 clinical centers. At baseline, 63% of patients had predominantly classic CNV; 25% had minimally classic CNV; and 12% had occult with no classic CNV. Mean lesion size (GLD) at baseline was 3140 microns and 89% of patients had subfoveal CNV. For data analysis, patients were divided into 2 groups: better VA (baseline VA 20/200 or better, mean 20/100+2) or poorer VA (baseline VA worse than 20/200–1, mean 20/640+2). Of the 335 patients, 200 had a 180–day VA assessment. By 180 days, patients had received a mean of 2.1 and 1.8 verteporfin PDT treatments in the better VA (n=137) and poorer VA (n=63) groups, respectively, and a mean of 1.0 adjunctive triamcinolone treatment in both groups. Mean change in VA from baseline was –8.6 letters (–1.8 lines) in patients with better VA at baseline, and +10.0 letters (+2.0 lines) in patients with poorer baseline VA. Complications were minimal and transient. Results will be discussed in the context of analyses of patients who received verteporfin PDT alone as previously reported from the Visudyne Patient Registry and from randomized controlled trials of verteporfin PDT. Conclusions: Although retrospective case series cannot substitute for randomized controlled trials, this retrospective analysis suggests a benefit in treating patients with the combination of verteporfin PDT and adjunctive intravitreal triamcinolone acetate. Several randomized clinical trials are underway to better assess the role of this combination treatment.
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