title: Transpupillary thermotherapy (TTT) with injections of triamcinolone acetonide under posterior Tenon's capsule in the treatment of exudative age-related macular degeneration (AMD).
abstract: OBJECTIVE
  To evaluate the efficacy of transpupillary thermotherapy (TTT) with injection of triamcinolone acetonide under posterior Tenon's capsule for exudative age-related macular degeneration (AMD).
  
  
  METHODS
  The study included two groups of patients with subfoveal choroidal neovascularization (CNV) due to AMD: group I (n = 20) received TTT alone and group II (n = 20) received TTT combined with sub-Tenon's injection of 40 mg of triamcinolone acetonide (TA). The best corrected visual acuity (BCVA), Amsler grid test, contrast sensitivity and fluorescein angiography (FA) at 10-12 weeks after treatment were compared to the baseline values.
  
  
  RESULTS
  The average age for group I was 72.3 years and for group II 74.6 years. Occult CNV was present in 54% and 43%; predominately classic in 22% and 25%; and minimally classic in 24% and 32% of group I and II respectively. The baseline BCVA in group I ranged from 0.02 to 0.2 and in group II--from 0.03 to 0.1. BCVA was maintained or improved in 7 patients (35%) in group I and in 12 eyes (60%) in group II. The deterioration of the BCVA was noted in 13 patients (65%) and in 8 patients (40%) in group I and II respectively. In 65% of eyes in group I and in 83% in group II the improvement in contrast sensitivity was observed. The rate of color vision improvement was 62% and 91%. Regression of metamorphopsia and/or scotoma in central visual field was observed in 11 cases (55%) and in 14 cases (70%) in group I and II respectively. FA showed complete or partial closure of CNV in 9 and 14 eyes (p = 0.02) in group I and II, respectively.
  
  
  CONCLUSIONS
  The results of our preliminary study indicate that TTT combined with sub-Tenon's injections of triamcinolone acetonide may be a beneficial treatment modality with tendency to better functional results than TTT alone, in patients with exudative AMD. However for the precise evaluation of efficacy of this therapy a larger group of patients and longer follow-up are necessary.
authors.affiliation: Department of Ophthalmology, Clinic of Ophthalmology and Ocular Oncology, Jagiellonian University, Medical College, Kraków, Poland.
authors.forename: Kubicka-Trzaska
authors.initials: KT
authors.lastname: Agnieszka
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003131:Combined Modality Therapy; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage*; D006801:Humans; D006979:Hyperthermia, Induced / Q000379:methods*; D058449:Intravitreal Injections; D008268:Macular Degeneration / Q000188:drug therapy / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011044:Poland; D058475:Tenon Capsule; D014222:Triamcinolone Acetonide / Q000008:administration & dosage*; D014792:Visual Acuity
chemical_list: D005938:Glucocorticoids; D014222:Triamcinolone Acetonide