Document Detail


Combined photodynamic therapy and intravitreal triamcinolone for nonsubfoveal choroidal neovascularization.
MedLine Citation:
PMID:  16141854     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To examine the 12-month results for a group of patients with nonsubfoveal choroidal neovascularization who were treated with combined photodynamic therapy (PDT) with verteporfin and intravitreal triamcinolone acetonide. METHODS: Patients with nonsubfoveal choroidal neovascularization, which was defined as either juxtafoveal or extrafoveal neovascularization, were treated with PDT immediately followed by an intravitreal injection of 4 mg of triamcinolone acetonide. Need for retreatment was based on fluorescein angiographic evidence of leakage at 3-month follow-up intervals. The main outcome measures were visual acuity and the proportion of patients developing subfoveal extension. RESULTS: Of the 15 patients, 9 were women and 6 were men (mean age +/- SD, 80 +/- 7.5 years). The mean baseline visual acuity was almost 20/60 (mean logMAR = 0.46), and 14 of the 15 eyes had juxtafoveal choroidal neovascularization. At 3, 6, and 9 months, the patients had significant improvement in the mean visual acuity (P = 0.002, 0.001, and 0.007, respectively), but at the end of the 12-month follow-up period, the mean visual acuity was slightly worse than 20/40 (mean logMAR = 0.34), which was not statistically significant at an alpha level adjusted for multiple comparisons of .013 (P = .057) as compared with the baseline visual acuity. One patient had subfoveal extension of choroidal neovascularization. The mean number of treatments was 1.9. Three patients (20%) developed an intraocular pressure of >24 mmHg during follow-up, a threshold used to institute pressure reduction therapy. No patient developed endophthalmitis. CONCLUSION: The number of patients in this pilot study was limited; however, the visual acuity response and the low incidence of subfoveal extension suggest that PDT combined with intravitreal triamcinolone for the treatment of nonsubfoveal choroidal neovascularization merits further investigation as a first-line treatment.
Authors:
Richard F Spaide; John Sorenson; Leandro Maranan
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Retina (Philadelphia, Pa.)     Volume:  25     ISSN:  0275-004X     ISO Abbreviation:  Retina (Philadelphia, Pa.)     Publication Date:  2005 Sep 
Date Detail:
Created Date:  2005-09-05     Completed Date:  2005-09-27     Revised Date:  2006-12-15    
Medline Journal Info:
Nlm Unique ID:  8309919     Medline TA:  Retina     Country:  United States    
Other Details:
Languages:  eng     Pagination:  685-90     Citation Subset:  IM    
Affiliation:
LuEsther T. Mertz Retinal Research Center, Manhattan Eye, Ear, and Throat Hospital, New York, New York, USA. rickspaide@ayhoo.com
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Choroidal Neovascularization / drug therapy*
Combined Modality Therapy
Female
Fluorescein Angiography
Glucocorticoids / therapeutic use*
Humans
Injections
Male
Middle Aged
Photochemotherapy*
Photosensitizing Agents / therapeutic use*
Pilot Projects
Porphyrins / therapeutic use*
Retreatment
Triamcinolone Acetonide / therapeutic use*
Visual Acuity
Vitreous Body
Chemical
Reg. No./Substance:
0/Glucocorticoids; 0/Photosensitizing Agents; 0/Porphyrins; 129497-78-5/verteporfin; 76-25-5/Triamcinolone Acetonide

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