title: Treatment of recurrent retinal angiomatous proliferation with intravitreal triamcinolone acetonide followed by photodynamic therapy with verteporfin: A retrospective case series.
abstract: OBJECTIVE
  The aim of this study was to report the effect on tolerability of combined treatment with intravitreal triamcinolone acetonide (IVT) and photodynamic therapy (PDT) with verteporfin in patients with stage II retinal angiomatous proliferation (RAP) who had been treated previously with PDT and presented with recurrent RAP (R-RAP).
  
  
  METHODS
  This was a retrospective case series of patients with R-RAP after PDT (1-5 treatments) treated once with IVT followed 1 month later by PDT. A visual acuity test, fluorescein and indocyanine green angiography, and optical coherence tomography were performed at baseline and at 1, 3, and 6 months.
  
  
  RESULTS
  Five patients (4 men, 1 woman; mean [SD] age, 76.8 [3.9] years) with 6 eyes diagnosed with stage II R-RAP who had previously been treated with PDT and who received an IVT injection and PDT within 1 month were included in the study. Best corrected visual acuity (BCVA) remained stable after IVT in 5 eyes (83%) and deteriorated in 1 eye (17%). After PDT, BCVA remained stable in 2 eyes (33%) and deteriorated in 4 eyes (67%). IVT treatment combined with PDT also reduced fluorescein leakage. Median lesion size increased 24% before PDT and 61% at 6 months after PDT. One eye had intraocular hypertension at 3 months, and 1 eye developed a pigment epithelial tear after PDT.
  
  
  CONCLUSIONS
  The results were limited by the number of eyes and relatively short follow-up, but in this study, PDT after IVT did not appear to be as effective or well tolerated in 5 patients who had already been treated with PDT and presented with R-RAP.
authors.affiliation: Department of Ophthalmology, Policlinico of Bari, University of Bari, Bari, Italy.
authors.forename: Nicola
authors.initials: N
authors.lastname: Cardascia
authors.affiliation: Department of Ophthalmology, Policlinico of Bari, University of Bari, Bari, Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Furino
authors.affiliation: Department of Ophthalmology, Policlinico of Bari, University of Bari, Bari, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Ferrara
authors.affiliation: Department of Ophthalmology, Policlinico of Bari, University of Bari, Bari, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Boscia
authors.affiliation: Department of Ophthalmology, Policlinico of Bari, University of Bari, Bari, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Alessio
keywords: intravitreal triamcinolone acetonide; photodynamic therapy; retinal angiomatous proliferation