Tags

Type your tag names separated by a space and hit enter

Triamcinolone acetonide as adjunctive treatment to verteporfin in neovascular age-related macular degeneration: a prospective randomized trial.
Ophthalmology 2007; 114(12):2183-9O

Abstract

PURPOSE

To examine the use of intravitreal triamcinolone acetonide (IVTA) as adjunctive therapy to photodynamic therapy (PDT) in the treatment of occult and minimally classic choroidal neovascularization (CNV) secondary to age-related macular degeneration (AMD).

DESIGN

Single-center prospective randomized pilot clinical trial.

PARTICIPANTS

Thirty eyes of 30 patients with occult or minimally classic CNV secondary to AMD.

METHODS

Patients were randomized prospectively to receive either PDT alone or combined PDT plus IVTA treatment for CNV secondary to AMD. Standard verteporfin PDT was performed in all patients. In the PDT plus IVTA group, a 12-mg intravitreal injection of triamcinolone acetonide was given 30 minutes after PDT. Active lesions were retreated every 3 months for 1 year.

MAIN OUTCOME MEASURES

Change in visual acuity and retreatment rate.

RESULTS

Mean visual acuity remained stable in the PDT plus IVTA group (-1.9 Early Treatment Diabetic Retinopathy Study [ETDRS] letters; P = 0.58), but declined significantly in the PDT alone group (-13.3 ETDRS letters; P = 0.02). The treatment rate was 1.13 in the PDT plus IVTA group and 3.6 in the PDT alone group (P<0.0001). Mean contrast sensitivity increased by 3.6 letters (P = 0.09) in the PDT plus IVTA group and decreased by -1.84 letters (P = 0.07) in the PDT alone group. Cataract progression was noted in 4 of 7 phakic eyes in the PDT plus IVTA group. Six patients (40%) in the combined PDT plus IVTA group required topical glaucoma therapy for control of elevated intraocular pressure.

CONCLUSIONS

This pilot study demonstrated effective stabilization of visual acuity and reduced treatment frequency at 12 months with combination PDT plus IVTA therapy versus PDT alone. Larger randomized trials are ongoing to determine the efficacy and risks of PDT with IVTA.

Authors+Show Affiliations

Ivey Eye Institute, University of Western Ontario, London, Canada. vchaudha@uwo.caNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

18054638

Citation

Chaudhary, Varun, et al. "Triamcinolone Acetonide as Adjunctive Treatment to Verteporfin in Neovascular Age-related Macular Degeneration: a Prospective Randomized Trial." Ophthalmology, vol. 114, no. 12, 2007, pp. 2183-9.
Chaudhary V, Mao A, Hooper PL, et al. Triamcinolone acetonide as adjunctive treatment to verteporfin in neovascular age-related macular degeneration: a prospective randomized trial. Ophthalmology. 2007;114(12):2183-9.
Chaudhary, V., Mao, A., Hooper, P. L., & Sheidow, T. G. (2007). Triamcinolone acetonide as adjunctive treatment to verteporfin in neovascular age-related macular degeneration: a prospective randomized trial. Ophthalmology, 114(12), pp. 2183-9.
Chaudhary V, et al. Triamcinolone Acetonide as Adjunctive Treatment to Verteporfin in Neovascular Age-related Macular Degeneration: a Prospective Randomized Trial. Ophthalmology. 2007;114(12):2183-9. PubMed PMID: 18054638.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Triamcinolone acetonide as adjunctive treatment to verteporfin in neovascular age-related macular degeneration: a prospective randomized trial. AU - Chaudhary,Varun, AU - Mao,Alex, AU - Hooper,Philip L, AU - Sheidow,Tom G, PY - 2006/06/28/received PY - 2007/02/12/revised PY - 2007/02/12/accepted PY - 2007/12/7/pubmed PY - 2007/12/19/medline PY - 2007/12/7/entrez SP - 2183 EP - 9 JF - Ophthalmology JO - Ophthalmology VL - 114 IS - 12 N2 - PURPOSE: To examine the use of intravitreal triamcinolone acetonide (IVTA) as adjunctive therapy to photodynamic therapy (PDT) in the treatment of occult and minimally classic choroidal neovascularization (CNV) secondary to age-related macular degeneration (AMD). DESIGN: Single-center prospective randomized pilot clinical trial. PARTICIPANTS: Thirty eyes of 30 patients with occult or minimally classic CNV secondary to AMD. METHODS: Patients were randomized prospectively to receive either PDT alone or combined PDT plus IVTA treatment for CNV secondary to AMD. Standard verteporfin PDT was performed in all patients. In the PDT plus IVTA group, a 12-mg intravitreal injection of triamcinolone acetonide was given 30 minutes after PDT. Active lesions were retreated every 3 months for 1 year. MAIN OUTCOME MEASURES: Change in visual acuity and retreatment rate. RESULTS: Mean visual acuity remained stable in the PDT plus IVTA group (-1.9 Early Treatment Diabetic Retinopathy Study [ETDRS] letters; P = 0.58), but declined significantly in the PDT alone group (-13.3 ETDRS letters; P = 0.02). The treatment rate was 1.13 in the PDT plus IVTA group and 3.6 in the PDT alone group (P<0.0001). Mean contrast sensitivity increased by 3.6 letters (P = 0.09) in the PDT plus IVTA group and decreased by -1.84 letters (P = 0.07) in the PDT alone group. Cataract progression was noted in 4 of 7 phakic eyes in the PDT plus IVTA group. Six patients (40%) in the combined PDT plus IVTA group required topical glaucoma therapy for control of elevated intraocular pressure. CONCLUSIONS: This pilot study demonstrated effective stabilization of visual acuity and reduced treatment frequency at 12 months with combination PDT plus IVTA therapy versus PDT alone. Larger randomized trials are ongoing to determine the efficacy and risks of PDT with IVTA. SN - 1549-4713 UR - https://www.unboundmedicine.com/medline/citation/18054638/Triamcinolone_acetonide_as_adjunctive_treatment_to_verteporfin_in_neovascular_age_related_macular_degeneration:_a_prospective_randomized_trial_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0161-6420(07)00184-4 DB - PRIME DP - Unbound Medicine ER -