SCIENTIFIC REPORT

Intravitreal triamcinolone with photodynamic therapy for subfoveal choroidal neovascularisation in age related macular degeneration

E Rechtman^1,2, R P Danis^1,3, L M Pratt¹ and A Harris¹

¹ Department of Ophthalmology, Indiana University School of Medicine, Indianapolis, IN, USA
² Department of Ophthalmology, Kaplan Medical Center, Rehovot, Israel
³ Department of Ophthalmology and Visual Sciences, University of Wisconsin Medical School, Madison, WI, USA

Correspondence to:
Correspondence to:
Dr R P Danis
Department of Ophthalmology and Visual Sciences, University of Wisconsin Medical School, Park West One, 406 Science Drive, Suite 400, Madison, WI, 53711-1068, USA; rdanis{at}rc.ophth.wisc.edu; ehudrechtman{at}yahoo.com

Aims: To report the effects of intravitreal triamcinolone acetonide (iTAAC) injections as an adjunctive treatment to photodynamic therapy (PDT) with verteporfin for new subfoveal choroidal neovascularisation (CNV) in age related macular degeneration (AMD).

Methods: We retrospectively reviewed the records of all AMD patients who had iTAAC within 6 weeks of their first PDT and had a follow up of one year or longer. The proportion of eyes after one year follow up that lost or gained 15 and 30 ETDRS letters, baseline and one year lesion greatest linear dimension (GLD), number of PDTs, and side effects were assessed.

Results: Fourteen patients were evaluated. Eleven received one initial combined treatment and three received an additional combined treatment after 6 months. Median follow up was 18 months (range 12 to 25 months). Overall, 7% gained 30 letters, 50% maintained stable vision, 14% lost 15–29 letters, and 29% lost 30 letters. Overall, mean GLD increased from 2580 (SD 1088) µm to 3946 (SD 1503) µm (p = 0.01). The mean number of PDTs during the first year was 2.57. Side effects were mild intraocular pressure elevation in 28.5% and cataract progression in 50% of phakic eyes.

Conclusions: iTAAC with PDT in AMD was found to be relatively safe and had reasonable results for lesions with some classic component.

Keywords: age related macular degeneration; photodynamic therapy; verteporfin; triamcinolone

Abbreviations: AMD, age related macular degeneration; CNV, choroidal neovascularisation; FA, fluorescein angiography; GLD, greatest linear dimension; iTAAC, intravitreal triamcinolone acetonide; PDT, photodynamic therapy; VA, visual acuity

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