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. 2004 Mar;88(3):344-7.
doi: 10.1136/bjo.2003.027177.

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

E Rechtman  1 , R P Danis, L M Pratt, A Harris
Affiliations

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

E Rechtman et al. Br J Ophthalmol. 2004 Mar.

Abstract

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 >or=15 and >or=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 >or=30 letters, 50% maintained stable vision, 14% lost 15-29 letters, and 29% lost >or=30 letters. Overall, mean GLD increased from 2580 (SD 1088) microm to 3946 (SD 1503) micro m (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.

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Figures

Figure 1
Figure 1
Eighty six year old man with systemic hypertension and pseudophakia, presented with new subfoveal choroidal neovascularisation due to age related macular degeneration in his right eye. At baseline, ETDRS letter score was 76 (20/60+1) and lesion greatest linear dimension was 2490 µm. (A) Red free image at baseline. Early (B), mid (C), and late (D) phases of fluorescein angiography at baseline show predominantly classic lesion with subretinal haemorrhage occupying 60% of the total lesion area.
Figure 2
Figure 2
Fluorescein angiography (FA) of the same man as in figure 1, 12 month visit. Treatment consisted of two combined iTAAC/PDT treatments, given at the same visit, at baseline and after 6 months, with an additional PDT at the 3 month visit. (A) Red free image. Early (B), mid (C), and late (D) phases of FA show subfoveal lesion with subretinal fibrosis without late leakage. One year ETDRS letter score was 72 (20/70+2). Intraocular pressure remained within normal limits throughout the follow up.
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