Background: To compare early treatment effect of reduced fluence versus standard photodynamic therapy (rPDT, sPDT, respectively) in combination with intravitreal triamcinolone (IVTA) in neovascular age-related macular degeneration.
Methods: Forty patients received either sPDT (group A, n = 20) or rPDT (group B, n = 20) each followed by same-day 4 mg IVTA. Patients were examined at baseline, day 1, week 1, 4 and 12. Main outcomes were visual acuity, central retinal thickness (CRT), choroidal perfusion and macular sensitivity (MS).
Results: Baseline characteristics were well balanced in both groups (p>0.05). At week 12, patients in group A had a mean loss of −3.7 letters compared with a gain of 3.4 letters in group B (p = 0.04, between both groups). Both treatment groups showed a similar course regarding CRT as well as MS (p>0.05). In 70% (14/20) of group A and 15% (3/20) of group B, a choroidal hypoperfusion in the area of treatment was observed after treatment (p<0.001). In 70% of group A and 55% of group B, a repeat treatment was indicated at week 12 (p = 0.55).
Conclusions: At month 3, the rPDT+IVTA group showed a significantly better visual outcome, less alteration of the choroid and a trend for lower recurrence rate than the sPDT+IVTA group. Further follow-up of this study will provide information on long-term functional results and treatment durability.
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Competing interests: Medication (verteporfin) was provided in part by Novartis Pharma AG, Basel, Switzerland. US-E is an owner of the patent on the use of green porphyrins in neovasculature of the eye under the guidelines of the Wellman Laboratories of Photomedicine, Harvard Medical School, Boston, Massachusetts. The remaining authors do not have any conflict of interest in the material presented in the article.
Ethics approval: The study protocol was approved by the Ethics Committee of the Medical University of Vienna, the Austrian health authorities, registered at the European Clinical Trials Database (EudraCT No 2005-000776-41).
Patient consent: Obtained.