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 either received sPDT (group A, n=20) or rPDT (group B, n=20) each followed by same day 4mg 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 the 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 win 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 retreatment was indicated at week 12 (p=0.55).
Conclusions: Combination therapy using a rPDT+IVTA showed a significant better visual outcome less alteration of the choroid and trend for lower recurrence rate than a sPDT+IVTA at week 12.
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