Prolongation of choroidal hypofluorescence following combined verteporfin photodynamic therapy and intravitreal triamcinolone acetonide injection.
OBJECTIVE
To determine the incidence and effect of persistent/prolonged choroidal hypofluorescence (PCH) following combined verteporfin photodynamic therapy and intravitreal triamcinolone acetate injection (PDT + IVTA) for age-related subfoveal choroidal neovascularization (CNVM).


METHODS
A retrospective review of all patients undergoing PDT + IVTA for CNVM from December 2003 through November 2004 was performed. Included patients underwent intravenous fundus fluorescein angiography (FA) preoperatively and 1 week and 3 months following PDT. FA presence of persistent choroidal hypofluorescence (PCH) 3 months postoperatively was graded in each eye by comparison with the 1 week postoperative FA. Twenty-seven eyes treated with PDT alone before December 2003 served as controls.


RESULTS
A total of 53 eyes of 46 patients were identified for study. At 3 months post treatment, PCH was noted in 37/53 eyes (70%) receiving PDT + IVTA combination therapy compared to only 3/27 (11%) control eyes treated with PDT alone (P<0.0001; Fisher two-tailed exact test).


CONCLUSIONS
The findings suggest that IVTA prolongs the native PDT effect manifest by post treatment FA CH. This phenomenon may reflect a mechanism by which IVTA enhances the effectiveness of PDT. Further study is necessary to confirm and elucidate this possible association.
Luttrull
Jeffrey K
JK
jkl@venturacountyretina.com
Spink
Charles J
CJ
D000368:Aged; D000369:Aged, 80 and over; D002829:Choroid / Q000378:metabolism*; D020256:Choroidal Neovascularization / Q000188:drug therapy*; D004357:Drug Synergism; D004359:Drug Therapy, Combination; D005260:Female; D005451:Fluorescein Angiography; D005453:Fluorescence; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D007267:Injections; D008268:Macular Degeneration / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D010778:Photochemotherapy; D017319:Photosensitizing Agents / Q000627:therapeutic use; D011166:Porphyrins / Q000627:therapeutic use*; D012189:Retrospective Studies; D014222:Triamcinolone Acetonide / Q000627:therapeutic use*; D000077362:Verteporfin; D014822:Vitreous Body
D005938:Glucocorticoids; D017319:Photosensitizing Agents; D011166:Porphyrins; D000077362:Verteporfin; D014222:Triamcinolone Acetonide