Combined photodynamic therapy and intravitreal triamcinolone for choroidal neovascularization secondary to punctate inner choroidopathy or of idiopathic origin: one-year results of a prospective series.
OBJECTIVE
To evaluate the efficacy and safety of combined intravitreal triamcinolone (IVTA) and photodynamic therapy (PDT) with verteporfin in the treatment of subfoveal choroidal neovascularization (CNV) due to punctate inner choroidopathy (PIC) or of idiopathic cause.


METHODS
Consecutive patients with subfoveal idiopathic and PIC CNV were prospectively recruited and received combined PDT and 4 mg IVTA injection. Patients were observed every 3 months for 1 year and retreatment was performed in the presence of angiographic leakage. Outcome measures included changes in the mean best-corrected visual acuity (BCVA), the proportion of patients who had stable or improved vision, and the mean number of treatments required during the 1-year period.


RESULTS
Fourteen patients (14 eyes) were recruited and all completed the 1-year follow-up. The mean age of the patients was 34.7 years. The mean logMAR BCVA improved significantly from 0.52 at baseline to 0.20 at 1 year (Wilcoxon signed-ranks test, P = 0.003). For the entire group, 13 (92.9%) eyes had stable or improved vision with a mean improvement of 3.2 lines (range, -3-7 lines). The mean number of treatments during the 1-year study period was 1.1 sessions. No serious ocular or systemic complications were encountered.


CONCLUSIONS
Combined PDT with IVTA seems to be a promising treatment strategy in the treatment of idiopathic CNV and CNV secondary to PIC as it resulted in fewer treatment sessions and superior visual improvement. Further study to assess its long-term safety and efficacy as the first line treatment is warranted.
Chan
Wai-Man
WM
Department of Ophthalmology & Visual Sciences, The Chinese University of Hong Kong, Hong Kong Eye Hospital, Kowloon, People's Republic of China. cwm6373@netvigator.com
Lai
Timothy Y Y
TY
Lau
Teresa T Y
TT
Lee
Vincent Y W
VY
Liu
David T L
DT
Lam
Dennis S C
DS
D000293:Adolescent; D000328:Adult; D015862:Choroid Diseases / Q000150:complications; D020256:Choroidal Neovascularization / Q000188:drug therapy* / Q000209:etiology; D004359:Drug Therapy, Combination; D005260:Female; D005451:Fluorescein Angiography; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D007267:Injections; D008297:Male; D008875:Middle Aged; D010778:Photochemotherapy; D017319:Photosensitizing Agents / Q000627:therapeutic use*; D011166:Porphyrins / Q000627:therapeutic use; D011446:Prospective Studies; D016896:Treatment Outcome; D014222:Triamcinolone Acetonide / Q000627:therapeutic use*; D000077362:Verteporfin; D014792:Visual Acuity; D014822:Vitreous Body
D005938:Glucocorticoids; D017319:Photosensitizing Agents; D011166:Porphyrins; D000077362:Verteporfin; D014222:Triamcinolone Acetonide