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Verteporfin therapy combined with intravitreal triamcinolone in all types of choroidal neovascularization due to age-related macular degeneration.
Ophthalmology. 2006 Jan; 113(1):14-22.O

Abstract

OBJECTIVE

To evaluate the efficacy and safety of photodynamic therapy with verteporfin combined with intravitreal triamcinolone in choroidal neovascularization secondary to age-related macular degeneration (AMD).

DESIGN

Prospective, noncomparative, interventional case series.

PARTICIPANTS

One hundred eighty-four patients undergoing treatment for neovascular AMD at one retinal referral center.

METHODS

One hundred eighty-four eyes of 184 consecutive patients (63.6% female, 36.4% male) with a mean age of 76.5 years and a follow-up of a median of 38.8 weeks (range, 12-103) were included in a case series. One hundred forty-eight (80.4%) patients had subfoveal choroidal neovascularization, 19 patients (10.3%) had juxtafoveal choroidal neovascularization, and 17 patients (9.2%) had extrafoveal choroidal neovascularization. Verteporfin photodynamic therapy was performed using the recommended standard procedure. A solution containing 25 mg of triamcinolone was injected intravitreally 16 hours after photodynamic therapy in 184 patients. The combined therapy procedure was repeated at the 3-month follow-up visits whenever persistent choroidal neovascularization leakage was documented angiographically.

MAIN OUTCOME MEASURES

Mean change in best-refracted visual acuity (VA) between baseline and the last visit, and number of treatments necessary to achieve absence of leakage.

RESULTS

Visual acuity improved in the majority of patients (baseline VA, mean 20/125) by a mean increase of 1.22 Snellen lines and 1.43 lines using laser interferometry (P<0.01). The mean number of required treatments was 1.21. Twenty-three eyes (12.5%) required 2 treatments, 6 eyes (3.26%) required 3 treatments, and 1 eye (0.5%) required 4 treatments. The combination treatment including laser and intravitreal steroid administration was well tolerated. Forty-six patients (25%) required glaucoma therapy due to a transient steroid-induced intraocular pressure (IOP) increase. Twelve patients (6.5%) were on topical medication for preexisting glaucoma. Two patients (1%) whose IOP increase could not be controlled with topical therapy required surgery.

CONCLUSIONS

Verteporfin photodynamic therapy combined with intravitreal triamcinolone may improve the outcome of standard verteporfin photodynamic therapy in the treatment of choroidal neovascularization secondary to AMD. A significant improvement in VA was observed in a majority of treated patients and was maintained during the maximum follow-up. In addition, retreatment rates were lower than anticipated.

Authors+Show Affiliations

Department of Ophthalmology, Klinikum Karlsruhe, Karlsruhe, Germany. 106020.560@compuserve.comNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

16360209

Citation

Augustin, Albert J., and Ursula Schmidt-Erfurth. "Verteporfin Therapy Combined With Intravitreal Triamcinolone in All Types of Choroidal Neovascularization Due to Age-related Macular Degeneration." Ophthalmology, vol. 113, no. 1, 2006, pp. 14-22.
Augustin AJ, Schmidt-Erfurth U. Verteporfin therapy combined with intravitreal triamcinolone in all types of choroidal neovascularization due to age-related macular degeneration. Ophthalmology. 2006;113(1):14-22.
Augustin, A. J., & Schmidt-Erfurth, U. (2006). Verteporfin therapy combined with intravitreal triamcinolone in all types of choroidal neovascularization due to age-related macular degeneration. Ophthalmology, 113(1), 14-22.
Augustin AJ, Schmidt-Erfurth U. Verteporfin Therapy Combined With Intravitreal Triamcinolone in All Types of Choroidal Neovascularization Due to Age-related Macular Degeneration. Ophthalmology. 2006;113(1):14-22. PubMed PMID: 16360209.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Verteporfin therapy combined with intravitreal triamcinolone in all types of choroidal neovascularization due to age-related macular degeneration. AU - Augustin,Albert J, AU - Schmidt-Erfurth,Ursula, Y1 - 2005/12/19/ PY - 2005/03/22/received PY - 2005/07/25/revised PY - 2005/09/01/accepted PY - 2005/12/20/pubmed PY - 2006/1/13/medline PY - 2005/12/20/entrez SP - 14 EP - 22 JF - Ophthalmology JO - Ophthalmology VL - 113 IS - 1 N2 - OBJECTIVE: To evaluate the efficacy and safety of photodynamic therapy with verteporfin combined with intravitreal triamcinolone in choroidal neovascularization secondary to age-related macular degeneration (AMD). DESIGN: Prospective, noncomparative, interventional case series. PARTICIPANTS: One hundred eighty-four patients undergoing treatment for neovascular AMD at one retinal referral center. METHODS: One hundred eighty-four eyes of 184 consecutive patients (63.6% female, 36.4% male) with a mean age of 76.5 years and a follow-up of a median of 38.8 weeks (range, 12-103) were included in a case series. One hundred forty-eight (80.4%) patients had subfoveal choroidal neovascularization, 19 patients (10.3%) had juxtafoveal choroidal neovascularization, and 17 patients (9.2%) had extrafoveal choroidal neovascularization. Verteporfin photodynamic therapy was performed using the recommended standard procedure. A solution containing 25 mg of triamcinolone was injected intravitreally 16 hours after photodynamic therapy in 184 patients. The combined therapy procedure was repeated at the 3-month follow-up visits whenever persistent choroidal neovascularization leakage was documented angiographically. MAIN OUTCOME MEASURES: Mean change in best-refracted visual acuity (VA) between baseline and the last visit, and number of treatments necessary to achieve absence of leakage. RESULTS: Visual acuity improved in the majority of patients (baseline VA, mean 20/125) by a mean increase of 1.22 Snellen lines and 1.43 lines using laser interferometry (P<0.01). The mean number of required treatments was 1.21. Twenty-three eyes (12.5%) required 2 treatments, 6 eyes (3.26%) required 3 treatments, and 1 eye (0.5%) required 4 treatments. The combination treatment including laser and intravitreal steroid administration was well tolerated. Forty-six patients (25%) required glaucoma therapy due to a transient steroid-induced intraocular pressure (IOP) increase. Twelve patients (6.5%) were on topical medication for preexisting glaucoma. Two patients (1%) whose IOP increase could not be controlled with topical therapy required surgery. CONCLUSIONS: Verteporfin photodynamic therapy combined with intravitreal triamcinolone may improve the outcome of standard verteporfin photodynamic therapy in the treatment of choroidal neovascularization secondary to AMD. A significant improvement in VA was observed in a majority of treated patients and was maintained during the maximum follow-up. In addition, retreatment rates were lower than anticipated. SN - 1549-4713 UR - https://www.unboundmedicine.com/medline/citation/16360209/Verteporfin_therapy_combined_with_intravitreal_triamcinolone_in_all_types_of_choroidal_neovascularization_due_to_age_related_macular_degeneration_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0161-6420(05)01034-1 DB - PRIME DP - Unbound Medicine ER -