Aims: To compare the relative efficacy of photodynamic therapy (PDT), PDT associated with intravitreal triamcinolone (PDT-IT) and PDT associated with periocular triamcinolone (PDT-PT) to treat retinal angiomatous proliferation (RAP) stage III.
Methods: Retrospective, interventional, non randomized multicentric study. The files, Optical Coherence Tomography (OCT) scans, indocyanine green and fluorescein angiograms of patients with RAP stage III who had been referred to a regional centre for PDT were retrospectively examined. Final visual acuity and chorioretinal atrophy were considered as main outcome indicators. The need to retreat and the appearance of recurrences were also considered.
Results: Forty-two eyes were treated by PDT as monotherapy, 18 eyes by PDT-PT and 19 eyes by PDT-IT. Mean age in each group was 79.1±5.2, 77.0±5.9 and 80.2±5.1 years, respectively. Mean initial best corrected visual acuity (BCVA) was 0.17±0.19, 0.21±0.20 and 0.20±0.18 respectively. Mean BCVA was 0.14±0.19, 0.17±0.15 and 0.17±0.23 respectively at six months (p= 0.27, 0.33 and 0.21 respectively) and 0.12±0.18, 0.10±0.10 and 0.17±0.26 respectively at twelve months (p=0.12, 0.05 and 0.60 respectively, comparing vision at 6 months and 12 months to base line, Student t test for paired data). Retinal pigment epithelium rips appeared in three eyes in Group 1, in one eye in Group 2 and in two eyes in Group 3.
Conclusion: Combined therapy PDT-IT may offer better results than PDT monotherapy and PDT associated with periocular triamcinolone in patients with RAP stage III.