Purchase this article with an account.
A.A. Moshfeghi, C.A. Puliafito, P.J. Rosenfeld; Verteporfin Therapy with Intravitreal Triamcinolone in Patients with Neovascular AMD . Invest. Ophthalmol. Vis. Sci. 2004;45(13):3159.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
Purpose: Verteporfin therapy prevents moderate vision loss in selected AMD patients with subfoveal choroidal neovascularization (CNV). Most of the vision loss occurs within the first 6 months of therapy. Several strategies have been used to minimize the extent of this vision loss including more frequent retreatments and modification of the photodynamic laser protocol. A recent report by Spaide et al. (Ophthalmol,110(8):1517–25) showed that the use of intravitreal triamcinolone acetonide (kenalog) in combination with verteporfin therapy appeared to reduce the need for retreatment and decrease the risk of vision loss compared with verteporfin therapy alone. An analysis is presented of AMD patients with subfoveal CNV treated with verteporfin therapy in combination with kenalog at the Bascom Palmer Eye Institute. Methods: A retrospective analysis was performed on consecutive AMD patients with subfoveal CNV treated with verteporfin photodynamic therapy (PDT) and kenalog. Best–corrected visual acuity testing, ophthalmological examinations, color fundus photography, and fluorescein angiography were performed. Follow–up evaluations were performed every 6–14 weeks. Additional therapy was performed every 10–14 weeks if fluorescein angiographic leakage was detected. Results: A total of 46 eyes received PDT with intravitreal kenalog from 01/01/2000 to 12/05/2003. Of the 16 eyes with at least 6 months follow–up, 10 received prior PDT. The median baseline visual acuity for patients with prior PDT was 20/200 and without prior PDT was 20/400. After a median follow–up period of 9.2 months (range, 6.3 to 16.8 months), the median visual acuity for patients with prior PDT was 20/400 and without prior PDT was 20/200. In the 10 patients with prior PDT, visual acuity improved ≥ 3 ETDRS equivalent lines in 1 patient (10%), stabilized in 4 patients (40%), and decreased ≥ 3 ETDRS equivalent lines in 5 patients (50%). In the 6 patients without prior PDT, visual acuity stabilized in 4 patients (67%) and decreased ≥ 3 ETDRS equivalent lines in 2 patients (33%). During the first 6 months of follow–up, only 6 (37.5%) eyes received 1 retreatment and none of the eyes received 2 retreatments. No endophthalmitis occurred and no additional safety concerns were identified. Conclusion: Patients receiving PDT with kenalog appeared to require fewer retreatments compared with the expected number of retreatments with PDT alone. Visual acuity outcomes were similar to the outcomes expected with PDT alone. These preliminary results suggest that intravitreal kenalog is a safe and cost–effective adjunctive therapy for patients receiving PDT.
This PDF is available to Subscribers Only