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SJ Moon, WF Mieler, ER Holz; Pilot Study of Intravitreal Injection of Triamcinolone Acetonide in Exudative Age-Related Macular Degeneration . Invest. Ophthalmol. Vis. Sci. 2002;43(13):1220.
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Purpose: To investigate the safety and efficacy of intravitreal injection of triamcinolone acetonide (Kenalog) in exudative age-related macular degeneration (AMD) patients with predominantly occult (<50% classic) subfoveal choroidal neovascularization (CNV). Methods: A randomized prospective pilot clinical trial involving a single injection of triamcinolone acetonide (4 mg/0.1 ml) into the vitreous cavity of treatment eyes (6 patients) versus a single injection of saline solution (0.1 ml) into the vitreous cavity of control eyes (2 patients) was performed. Complete ocular examination with LogMAR visual acuity assessment was performed at baseline, 1 day, 1, 3, and 6 months following enrollment. Fluorescein angiography was performed at baseline, 3, and 6 months. Results: Overall, the treatment eyes had more LogMAR visual acuity improvement (-0.23 to -0.28) than the control eyes (-0.05 to -0.1) throughout the study. Three treatment eyes demonstrated significant visual improvement at 1 day (-0.43), 1 month (-0.3), 3 months (-0.47), and 6 months (-0.33). The other treatment eyes and the control eyes remained relatively stable with their visual acuity change staying within -0.17. Fluorescein angiography showed stability or improvement with reduction in leakage in the treatment eyes at 3 and 6 months. The treatment eyes that responded well appeared to have occult CNV with minimal or no classic component. One treatment eye experienced a transient increase in intraocular pressure which necessitated medical intervention. There was no significant cataract progression in the treatment eyes. Conclusion: Intravitreal triamcinolone appears to be relatively well tolerated and may provide immediate visual improvement in some patients with exudative AMD with predominantly occult CNV. The effect may persist for at least up to 6 months. This observation may result from a combination of the anti-inflammatory and anti-angiogenic properties of triamcinolone. Further study is ongoing.
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