Article
Photodynamic therapy combined with intravitreal injection of Triamcinolone: outcome in patients with persistent choroidal neovascularization
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Published: | September 22, 2004 |
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Outline
Text
Objective
To outline the effects of photodynamic therapy (PDT) combined with intravitreal injection of triamcinolon in patients having persistent CNV. We examined patients with persistent CNV who have already been treated with PDT. The period of investigation was between November 2003 and February 2004.
Methods
In all 12 patients were treated. Seven of these patients were followed-up in an average time period of 10 weeks( 6-17 weeks) . From these 7 patients who were examined, six were diagnosed with age related macula degeneration and had an average age of 72.6 years. One 54-year-old patient had pathological myopia. Prior to treatment all patients showed persistent and actively exsudating CNV in the fluorescein angiography (FAG) even though they had been treated with PDT. The patients were retreated with standardized PDT in addition with intravitreal injection of triamcinolone (4mg). Visual acuity (best corrected), extent of leakage out of the CNV in the FAG ( using HRA II) and foveal thickness using the OCT (optical coharent tomography; OCT III Zeiss, Humphrey) were examined.
Results
The mean number of PDT carried out prior to the combined treatment with PDT and intravitreal triamcinolone injection was 1,4. All Patients showed no side effects after this treatment. Overall three out of the 7 patients had a gain (more than 1 Snellen lines), three maintained (±1 Snellen line) and one had a loss (±1 Snellen line) in visual acuity. Leakage out of the CNV as seen in the FAG was reduced in all patients after the treatment except for one patient where the leakage remained undiminished. Foveal thickness was evaluated in 4 patients using the OCT. One patient showed a reduction (> 10%), two showed no alteration (±10%) and one patient had a gain in foveal thickness (> 10%).
Conclusions
Intravitreal injection of triamcinolone is a safe method for treating patients with persistent CNV who have undergone previous therapies. The results of this investigation are promising and have to be confirmed with long-term clinical studies.