Purpose: To evaluate the efficacy and safety of triple therapy consisting single-session photodynamic therapy (PDT), intravitreal bevacizumab (IVB) and intravitreal triamcinolone (IVTA) for treatment of neovascular age-related macular degeneration (AMD).
Methods: Consecutive patients with subfoveal choroidal neovascularization (CNV) secondary to AMD were treated with PDT,IVB and IVTA. IVB was given at 3 month for residual leakage. Best corrected Snellen visual acuity (BCVA) and fluorescein angiography (FA) were performed prior to treatment. BCVA, intraocular pressure (IOP), presence of vitritis were documented at 1 and 6 weeks, 3 and 6 months. FA was repeated at 3 and 6 months. Outcome measures included visual improvement measured by logMAR equivalent, angiographic evident of leakage and safety profile.
Results: 36 eyes of 33 patients, aged 76.4+/-10.5 years with mean follow up of 14.7 (6.9-19.2) months were analyzed. Baseline logMAR acuity was 1.22+/-0.71. Mean logMAR acuity was 1.14+/-0.62 and 1.18+/- 0.63 at 3 and 6 months respectively. At 6 months, 61.1% got stable or gaining vision and 27.8% gained 3 or more lines. Twenty-eight eyes (77.8%) achieved CNV resolution by single session of triple therapy. One eye lost more than 6 lines, 3 eyes got significant cataract requiring surgery and 2 got persistent raised IOP at 6 months. None resulted in endophthalmitis or reported thrombo-embolic event.
Conclusions: Short term results of single session triple therapy suggested that it might be a useful treatment option for neovascular AMD. However, risk and benefits of using IVTA in addition to combined PDT and IVB warrant further evaluation.
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