Visual acuity and contrast sensitivity outcomes in Indian eyes undergoing photodynamic therapy with intravitreal injection of triamcinolone acetonide in age-related macular degeneration.
OBJECTIVE
To evaluate photodynamic therapy (PDT) with verteporfin along with intravitreal triamcinolone acetonide (IVTA) in the treatment of neovascular age-related macular degeneration (AMD).


METHODS
This prospective interventional case series included 23 patients (23 eyes) of choroidal neovascularization due to neovascular AMD who were treated with PDT with verteporfin followed by an injection of 4 mg IVTA. The main outcome measures were visual acuity (VA), contrast sensitivity, retreatment frequency with PDT (and triamcinolone) and frequency of side-effects.


RESULTS
Twenty-three eyes underwent PDT with verteporfin followed by IVTA one week later. All patients were followed up for one year. Initial VA ranged from 20/32 to 20/800 and final VA ranged from 20/40 to 20/500 at the end of 12 months. VA stabilized (that is loss/gain < 2 lines) in 19 (82%) eyes. Contrast sensitivity also improved in 16/23 eyes (70%). Lesion type and patient's age had no influence on the outcome, but baseline VA had a borderline statistically significant effect (P =0.059). Six eyes (27%) had an increase in intraocular pressure that required therapy. There were no cases of endophthalmitis, but four eyes (18%) developed significant cataract that required surgery during the follow-up period.


CONCLUSIONS
The combination of PDT along with IVTA improves contrast sensitivity and stabilizes vision during one-year follow-up.
Kumar
Atul
A
Vitreous-Retina Service, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India. akum66mm@del6.vsnl.net.in
Sinha
Subijay
S
Kumar
Vikram
V
D000368:Aged; D020533:Angiogenesis Inhibitors / Q000008:administration & dosage* / Q000627:therapeutic use; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D044466:Asian People; D015350:Contrast Sensitivity; D005260:Female; D006801:Humans; D007194:India; D007267:Injections; D008268:Macular Degeneration / Q000188:drug therapy* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D010778:Photochemotherapy; D017319:Photosensitizing Agents / Q000627:therapeutic use; D011166:Porphyrins / Q000627:therapeutic use; D011446:Prospective Studies; D014222:Triamcinolone Acetonide / Q000008:administration & dosage* / Q000627:therapeutic use; D000077362:Verteporfin; D014792:Visual Acuity; D014822:Vitreous Body
D020533:Angiogenesis Inhibitors; D000893:Anti-Inflammatory Agents; D017319:Photosensitizing Agents; D011166:Porphyrins; D000077362:Verteporfin; D014222:Triamcinolone Acetonide