Photodynamic therapy and high-dose intravitreal triamcinolone to treat exudative age-related macular degeneration: 2-year outcome.

Abstract

To evaluate the efficacy of photodynamic therapy (PDT) and high-dose intravitreal triamcinolone acetonide (TA) injection to treat choroidal neovascularization (CNV) associated with age-related macular degeneration (AMD) at the 2-year follow-up. In this prospective, consecutive, comparative, nonrandomized, interventional case series, 30 eyes of 30 consecutive patients with subfoveal CNV associated with AMD were treated by PDT followed by intravitreal injection of 19.4 +/- 2.1 mg TA. Fifteen eyes were naive to treatment (group 1), and 15 had been treated previously by PDT alone (group 2). A group of 15 eyes of 15 patients treated by PDT alone served as controls. The number of Snellen lines gained or lost and PDT sessions were evaluated. Best-corrected visual acuity (BCVA) did not change significantly in group 1 from baseline (0.0 +/- 3.4 Snellen line; range, -5 to 9 Snellen lines; P = 0.81); group 2 lost an average -0.6 +/- 2.5 line (range, -7 to 3 Snellen lines) (P = 0.41), and the control group lost an average of -2.2 +/- 3.4 lines (range, -8 to 2 Snellen lines) (P = 0.03, Wilcoxon signed rank test). The average number of PDT sessions during the 24-month follow-up was 1.9, 1.2, and 3.9 for group 1, group 2, and the control group, respectively. Two years after combined PDT/high-dose intravitreal TA to treat AMD-associated CNV, final BCVA was stable, and the need for retreatment was reduced compared with historical controls.