Efficacy of intravitreal and periocular triamcinolone associated with photodynamic therapy for treatment of retinal angiomatous proliferation.
OBJECTIVE
To compare the relative efficacy of photodynamic therapy (PDT), PDT associated with intravitreal triamcinolone (PDT-IT) and PDT associated with periocular triamcinolone (PDT-PT) for treatment of retinal angiomatous proliferation (RAP) stage III.


METHODS
Retrospective, interventional, non-randomised multicentric study. The files, optical coherence tomography scans, indocyanine green and fluorescein angiograms of patients with RAP stage III who had been referred to a regional centre for PDT were retrospectively examined. Final visual acuity and chorioretinal atrophy were considered to be the main outcome indicators. The need to re-treat and recurrences were also considered.


RESULTS
Forty-two eyes were treated by PDT as monotherapy, 18 eyes by PDT-PT, and 19 eyes by PDT-IT. The mean (SD) age in each group was 79.1 (5.2), 77.0 (5.9) and 80.2 (5.1) years, respectively. The mean (SD) initial best corrected visual acuity (BCVA) was 0.17 (0.19), 0.21 (0.20) and 0.20 (0.18), respectively. Mean BCVA was 0.14 (0.19), 0.17 (0.15) and 0.17 (0.23), respectively, at 6 months (p = 0.27, 0.33 and 0.21, respectively) and 0.12 (0.18), 0.10 (0.10) and 0.17 (0.26), respectively, at 12 months (p = 0.12, 0.05 and 0.60, respectively, comparing vision at 6 months and 12 months with baseline; Student t test for paired data). Retinal pigment epithelium rips appeared in three eyes in group 1, in one eye in group 2, and in two eyes in group 3.


CONCLUSIONS
Combined PDT-IT may offer better results than PDT monotherapy or PDT-PT in patients with RAP stage III.
Montero
J A
JA
Ophthalmology Unit, Pío del Río Hortega University Hospital, C/Rondilla de Sta. Teresa 9, Valladolid, Spain. javmonmor@hotmail.com
Ruiz-Moreno
J M
JM
Sanabria
M R
MR
Fernandez-Munoz
M
M
D000368:Aged; D000369:Aged, 80 and over; D004341:Drug Evaluation; D004359:Drug Therapy, Combination; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage* / Q000627:therapeutic use; D006801:Humans; D007267:Injections; D008268:Macular Degeneration / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D008297:Male; D009915:Orbit; D010778:Photochemotherapy / Q000379:methods*; D015861:Retinal Neovascularization / Q000150:complications; D012189:Retrospective Studies; D016896:Treatment Outcome; D014222:Triamcinolone Acetonide / Q000008:administration & dosage* / Q000627:therapeutic use; D014792:Visual Acuity / Q000187:drug effects; D014822:Vitreous Body
D005938:Glucocorticoids; D014222:Triamcinolone Acetonide