Reduced fluence versus standard photodynamic therapy in combination with intravitreal triamcinolone: short-term results of a randomised study.
BACKGROUND
To compare early treatment effect of reduced fluence versus standard photodynamic therapy (rPDT, sPDT, respectively) in combination with intravitreal triamcinolone (IVTA) in neovascular age-related macular degeneration.


METHODS
Forty patients received either sPDT (group A, n = 20) or rPDT (group B, n = 20) each followed by same-day 4 mg IVTA. Patients were examined at baseline, day 1, week 1, 4 and 12. Main outcomes were visual acuity, central retinal thickness (CRT), choroidal perfusion and macular sensitivity (MS).


RESULTS
Baseline characteristics were well balanced in both groups (p>0.05). At week 12, patients in group A had a mean loss of -3.7 letters compared with a gain of 3.4 letters in group B (p = 0.04, between both groups). Both treatment groups showed a similar course regarding CRT as well as MS (p>0.05). In 70% (14/20) of group A and 15% (3/20) of group B, a choroidal hypoperfusion in the area of treatment was observed after treatment (p<0.001). In 70% of group A and 55% of group B, a repeat treatment was indicated at week 12 (p = 0.55).


CONCLUSIONS
At month 3, the rPDT+IVTA group showed a significantly better visual outcome, less alteration of the choroid and a trend for lower recurrence rate than the sPDT+IVTA group. Further follow-up of this study will provide information on long-term functional results and treatment durability.
Sacu
S
S
Medical University of Vienna, Department of Ophthalmology, Vienna, Austria. stefan.sacu@meduniwien.ac.at
Varga
A
A
Michels
S
S
Weigert
G
G
Polak
K
K
Vécsei-Marlovits
P V
PV
Schmidt-Erfurth
U
U
D000368:Aged; D020256:Choroidal Neovascularization / Q000503:physiopathology; D003131:Combined Modality Therapy; D004305:Dose-Response Relationship, Drug; D004812:Epidemiologic Methods; D005260:Female; D005451:Fluorescein Angiography / Q000187:drug effects; D005938:Glucocorticoids / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D008268:Macular Degeneration / Q000175:diagnosis*; D008297:Male; D010778:Photochemotherapy / Q000379:methods; D016896:Treatment Outcome; D014222:Triamcinolone Acetonide / Q000008:administration & dosage* / Q000009:adverse effects; D042461:Vascular Endothelial Growth Factor A / Q000187:drug effects; D014792:Visual Acuity / Q000502:physiology
D005938:Glucocorticoids; D042461:Vascular Endothelial Growth Factor A; D014222:Triamcinolone Acetonide