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E. Rechtman, R.P. Danis, L.M. Pratt, A. Harris; The Safety and Efficacy of Photodynamic Therapy With Verteporfin Combined With Intravitreal Triamcinolone Acetonide Injections for the Treatment of New Subfoveal Choroidal Neovascularization Due to Age-Related Macular Degeneration . Invest. Ophthalmol. Vis. Sci. 2003;44(13):1742.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: To evaluate the safety and efficacy of photodynamic therapy (PDT) with verteporfin combined with 4.0 mg intravitreal triamcinolone acetonide (iTAAC) injections for the treatment of new subfoveal choroidal neovascularization (CNV) due to age-related macular degeneration (AMD). Methods: A retrospective analysis of all AMD patients who were treated with both PDT with verteporfin and iTAAC injections for new subfoveal CNV. The proportion of eyes that lost 15 or more and 30 or more ETDRS letters, mean logMAR visual acuity, lesion greatest linear dimension (GLD), and side effects were assessed. Results: Twenty-two patients with new subfoveal neovascular AMD were evaluated. At baseline, 7 had predominantly classic CNV, 8 had minimally classic CNV, and 7 had pure occult CNV by angiography. The mean follow-up was 13± 4.8 months, and the subjects received on average 2.8±1 PDT treatments and 1.6±0.8 iTAAC injections. Overall, 50% and 36.4% had lost 15 or more and 30 or more ETDRS letters, respectively. Mean logMAR visual acuity changed from 0.55±0.28 at baseline to 0.96±0.61 at the final visit. Mean lesion GLD increased from 2648±961µm at baseline to 3977±1334µm at the final visit. Side effects consisted of worsening of the cataract in 60% of the phakic eyes, mostly of the nuclear sclerosis type, and transient IOP rise in 36.4% of subjects. Those with predominantly and minimally classic CNV fared better than those with purely occult CNV, with loss of 15 or more ETDRS letters in 40% versus 71%, respectively. The number of PDT treatments averaged 2.4±1 in the group with some classic component and 3.6±0.5 in the occult group. Conclusions: In a retrospective cohort study, combination therapy of PDT with iTAAC to new subfoveal CNV due to AMD, with any classic component was found to be relatively safe and showed at least similar visual acuity results to those found in the Treatment of AMD with PDT (TAP) study, but with fewer PDT treatments. This treatment did not show beneficial results to those with pure occult CNV. Further studies are merited based on these results.
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