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J. Arevalo, A.J. Mendoza, C.F. Fernandez; Photodynamic Therapy with Indocyanine Green (i-PDT) Combined with Intravitreal Triamcinolone Acetonide for Choroidal Neovascularization . Invest. Ophthalmol. Vis. Sci. 2003;44(13):3155.
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Purpose: To determine if photodynamic therapy with indocyanine green (i-PDT) combined with intravitreal triamcinolone acetonide (TA) can improve the chance of stabilizing or improving vision in patients with choroidal neovascularization (CNV). Methods: Comparative interventional non-randomized case series. Eighteen patients (24 eyes) participated in the study. Choroidal neovascularization was present in 15 patients (19 eyes) with age-related macular degeneration (AMD), 2 patients (4 eyes) with pathologic myopia (PM), and one patient (1 eye) had idiopathic CNV. Twelve eyes of 8 patients were treated with i-PDT immediately followed by an intravitreal injection of 4 mg of TA (Group A), and 12 eyes of 10 patients were treated with i-PDT only (Group B). Patients had a mean follow-up of 3 months (range: 1 week to 6 months), and were followed with fluorescein angiography (FA) and optical coherence tomography (OCT). Visual results were compared between both groups. Patients underwent single or two sessions of i-PDT. Results: Etiology of CNVs for Group A was AMD (9 eyes, 75%), and pathologic myopia (3 eyes, 25%), and for Group B etiology was AMD (10 eyes, 83.3%), PM (1 eye, 8.3%), and idiopathic (1 eye, 8.3%). In Group A, visual acuity showed stability in 6 eyes (50%), improvement in 5 eyes (41.6%), and worsening of visual acuity (VA) in 1 eye (8.3%). Group B presented VA stability in 8 eyes (66.6%), improvement in 2 eyes (16.6%), and worsening of visual acuity in 1 eye (8.3%). A significant regression of the CNV, and diminishing of subretinal fluid was demonstrated with FA and OCT in both two groups. There were no complications related to the procedures. Conclusions: Combined i-PDT and intravitreal triamcinolone may provide stability or improvement in visual acuity and fundus findings in choroidal neovascularization. These findings must be considered preliminary and should be followed by further investigation.
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