Photodynamic therapy with verteporfin and intravitreal triamcinolone acetonide in the treatment of neovascular age-related macular degeneration.
OBJECTIVE
To examine the efficacy of photodynamic therapy (PDT) with verteporfin and intravitreal triamcinolone acetonide in the treatment of neovascular age-related macular degeneration (AMD).


METHODS
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.
Ergun
Erdem
E
Department of Ophthalmology, Sanatorium Hera, Vienna, Austria. erdem.ergun@chello.at
Maár
Noémi
N
Ansari-Shahrezaei
Siamak
S
Wimpissinger
Barbara
B
Krepler
Katharina
K
Wedrich
Andreas
A
Stur
Michael
M
D000368:Aged; D020256:Choroidal Neovascularization / Q000188:drug therapy* / Q000209:etiology; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D007267:Injections; D008268:Macular Degeneration / Q000150:complications / Q000188:drug therapy*; D008297:Male; D010778:Photochemotherapy; D017319:Photosensitizing Agents / Q000009:adverse effects / Q000627:therapeutic use*; D011166:Porphyrins / Q000009:adverse effects / Q000627:therapeutic use*; D019233:Retreatment; D012189:Retrospective Studies; D014222:Triamcinolone Acetonide / Q000009:adverse effects / Q000627:therapeutic use*; D000077362:Verteporfin; D014792:Visual Acuity; D014822:Vitreous Body
D005938:Glucocorticoids; D017319:Photosensitizing Agents; D011166:Porphyrins; D000077362:Verteporfin; D014222:Triamcinolone Acetonide