Combined Photodynamic Therapy (PDT) with Subtenon Triamcinolone Acetonide for CNV in AMD and Non-AMD Patients

Abstract

Abstract: : Purpose: We report the short term visual acuity and fluorescein angiographic effects of a single photodynamic therapy treatment combined with subtenon triamcinolone acetonide (TA) injection in AMD and non-AMD patients with choroidal neovascular membranes in a pilot study. Methods: The non-randomized prospective clinical interventional study included 8 eyes of 8 patients having predominantly classic subfoveal choroidal neovascular membranes divided in 2 groups – 5 AMD patients and 3 non-AMD patients. Standardized visual acuity, anterior segment biomicroscopy, IOP measure, fundus examination and fluorescein angiography were recorded at baseline and during follow up (range 4 to 12 months). Five days after treatment with photodynamic therapy using verteporfin (6 mg/m2) in a standard fashion, all patients received a 40 mg subtenon injection of triamcinolone acetonide. Results: The mean visual acuity improved 1 line (range 5 to –2 lines) in the AMD group and 4.3 lines (range 6 to 2 lines) in the Non-AMD group from baseline to the follow up at week 12. No leakage in the primary lesion was noticed in 2 eyes of the AMD group and in all eyes in the non-AMD subgroup. Secondary elevation of the IOP was observed in 2 patients 2 weeks after the TA injection were prescribed anti-glaucoma medications. No major complications were observed. Conclusion: These preliminary data suggest this combined approach for treatment of choroidal neovascular membranes may have a remarkable benefit in the Non AMD group of patients providing a short term improvement of visual acuity after a single photodynamic therapy treatment and some benefit in the AMD group.

Keywords: choroid: neovascularization • age-related macular degeneration • photodynamic therapy