A new treatment regimen in combined intravitreal injection of triamcinolone acetonide and photodynamic therapy.
BACKGROUND
Combined photodynamic therapy (PDT) and intravitreal injection of triamcinolone acetonide is a new option in the treatment of the neovascular form of age-related macular degeneration. With the aim of increasing safety and efficacy we examined whether it is possible to administer the intravitreal injection prior to PDT.


METHODS
Patients with retinal angiomatous proliferation, who have an unfavourable prognosis when treated with PDT alone, were recruited to this study. Intravitreal injection of triamcinolone acetonide was applied 1 day before PDT. Distance acuity testing, retinal thickness measurement and fluorescein angiography were performed before treatment and 6 weeks and 3 months thereafter.


RESULTS
Twenty-five patients were included: 18 were female, 7 male. Their mean age was 79 years. The distance acuity was 68 letters before treatment and at the follow-up examinations. The retinal thickness decreased significantly from mean 470.8 microm to 335.4 microm at week 6 and 360.8 microm at month 3. At month 3, 48% showed signs of activity in the fluorescein angiography needing retreatment. Visualisation of the fundus was not reduced by the triamcinolone crystals.


CONCLUSIONS
PDT was possible without difficulty after intravitreal injection of triamcinolone acetonide. Stabilisation of the visual acuity was possible, although only eyes with retinal angiomatous proliferation were included.
Krebs
Ilse
I
Department of Ophthalmology, Rudolf Foundation Clinic, Juchgasse 25, 1030 Vienna, Austria. Ilse.Krebs@wienkav.at
Binder
Susanne
S
Stolba
Ulrike
U
D000368:Aged; D000369:Aged, 80 and over; D020256:Choroidal Neovascularization / Q000188:drug therapy*; D003131:Combined Modality Therapy; D005260:Female; D005451:Fluorescein Angiography; D005938:Glucocorticoids / Q000008:administration & dosage*; D006801:Humans; D007208:Indocyanine Green; D007267:Injections; D008268:Macular Degeneration / Q000188:drug therapy*; D008297:Male; D010778:Photochemotherapy; D011446:Prospective Studies; D015861:Retinal Neovascularization / Q000188:drug therapy*; D041623:Tomography, Optical Coherence; D014222:Triamcinolone Acetonide / Q000008:administration & dosage*; D014792:Visual Acuity; D014822:Vitreous Body
D005938:Glucocorticoids; D014222:Triamcinolone Acetonide; D007208:Indocyanine Green