Photodynamic Therapy With Verteporfin and Intravitreal Triamcinolone Acetonide in the Treatment of Neovascular Age-related Macular Degeneration - 18/08/11
, Noémi Maár, MD b, Siamak Ansari-Shahrezaei, MD b, Barbara Wimpissinger, MD c, Katharina Krepler, MD c, Andreas Wedrich, MD d, Michael Stur, MD b
Inquiries to Erdem Ergun, MD, Department of Ophthalmology, Sanatorium Hera, Loeblichgasse 14, A-1090 Vienna, AustriaRésumé |
Purpose |
To examine the efficacy of photodynamic therapy (PDT) with verteporfin and intravitreal triamcinolone acetonide in the treatment of neovascular age-related macular degeneration (AMD).
Design |
Retrospective, interventional case series.
Methods |
Sixty eyes of 56 patients with neovascular AMD were treated with PDT with verteporfin followed by an intravitreal injection of 4 mg triamcinolone acetonide. The main outcome measures were visual acuity (VA), retreatment frequency with PDT (and triamcinolone), and frequency of side effects.
Results |
Mean follow-up was 15.9 months (range 12 to 30 months, median 15 months). Twenty-three (38.3%) of 60 eyes had a stable result at 12 months’ follow-up (that is, loss/gain <three lines) and 34 (56.7%) of 60 had a loss of 3 lines or more. Three patients (5%) had an improvement of 3 lines or more. Lesion type, patient age, and lesion size had no influence on the outcome, but baseline VA had a statistically significant effect (P = .006). The median number of PDT–intravitreal triamcinolone acetonide treatments was one. One-third (20 of 60) of all eyes had an increase in intraocular pressure (IOP) that required therapy. There were no cases of endophthalmitis, but 13 patients (21.6%) developed severe cataract that required surgery.
Conclusions |
The combination of PDT and intravitreal triamcinolone acetonide requires careful consideration as a treatment option for neovascular AMD. In our case series, this treatment combination did not prevent a considerable decrease in VA. The main benefit of this combination treatment was a low number of verteporfin treatments. Baseline VA was the main predictor of the final outcome.
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| Supported in part by an unrestricted Scientific Financial Grant by Novartis AG (Basel, Switzerland). |
Vol 142 - N° 1
P. 10 - juillet 2006 Retour au numéro
Article précédent
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