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Macular Degeneration

Combination treatment with reduced-fluence photodynamic therapy and intravitreal injection of triamc

PURPOSE: To evaluate combination treatment with reduced-fluence photodynamic therapy (PDT) and intravitreal triamcinolone acetonide (IVT) injection for choroidal neovascularization (CNV) in age-related macular degeneration (AMD). METHODS: This is a retrospective consecutive case series of 23 previously untreated eyes of 22 patients with subfoveal CNV secondary to AMD. Six eyes were treated with 50 J/cm; 8, with 40 J/cm; and 9, with 25 J/cm. PDT was immediately followed by a 4-mg IVT injection. Patients were observed for 6 months at 6-week intervals. RESULTS:: The 50 J/cm subset lost a mean of 2.2 lines of Snellen visual acuity at the 6-month follow-up compared with a 1-line lost in the 40 J/cm subset and a 0.9-line gain in the 25 J/cm subset. In the 50 J/cm subset, 60% lost < or =3 lines of Snellen visual acuity, 33% gained > or =0 line, and 33% gained > or =3 lines. In the 40 J/cm subset, 75% lost < or =3 lines of Snellen visual acuity, 50% gained > or =0 line, and 25% gained > or =3 lines. In the 25 J/cm subset, 89% lost < or =3 lines of Snellen visual acuity, 56% gained > or =0 line, and 33% gained > or =3 lines. Fifty percent of the 50 J/cm subset, 50% of the 40 J/cm subset, and 33% of the 25 J/cm subset required retreatment by 6 months. CONCLUSION: Although the sample in this study was small, there was a dose-response trend toward better visual outcomes and fewer treatments in the group treated with IVT injection and reduced-fluence PDT. This study along with other previously reported work suggests that studies using PDT in combination treatment for CNV should consider adding a reduced-fluence PDT arm.





Seattle, WA
USA

Departments Name: Department of Ophthalmology
Institution name: University of Washington
Authors: Singh CN, Saperstein DA.
Journal Name: Retina
Data: 2008, Jun
Volume: 28(6):789-93
Country: USA



Other Categories:
 Macular Degeneration