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Combination treatment with reduced-fluence photodynamic therapy and intravitreal injection of triamcinolone for subfoveal choroidal neovascularization in macular degeneration.
Retina. 2008 Jun; 28(6):789-93.R

Abstract

PURPOSE

To evaluate combination treatment with reduced-fluence photodynamic therapy (PDT) and intravitreal triamcinolone acetonide (IVT) injection for choroidal neovascularization (CNV) in age-related macular degeneration (AMD).

METHODS

This is a retrospective consecutive case series of 23 previously untreated eyes of 22 patients with subfoveal CNV secondary to AMD. Six eyes were treated with 50 J/cm; 8, with 40 J/cm; and 9, with 25 J/cm. PDT was immediately followed by a 4-mg IVT injection. Patients were observed for 6 months at 6-week intervals.

RESULTS

: The 50 J/cm subset lost a mean of 2.2 lines of Snellen visual acuity at the 6-month follow-up compared with a 1-line lost in the 40 J/cm subset and a 0.9-line gain in the 25 J/cm subset. In the 50 J/cm subset, 60% lost < or =3 lines of Snellen visual acuity, 33% gained > or =0 line, and 33% gained > or =3 lines. In the 40 J/cm subset, 75% lost < or =3 lines of Snellen visual acuity, 50% gained > or =0 line, and 25% gained > or =3 lines. In the 25 J/cm subset, 89% lost < or =3 lines of Snellen visual acuity, 56% gained > or =0 line, and 33% gained > or =3 lines. Fifty percent of the 50 J/cm subset, 50% of the 40 J/cm subset, and 33% of the 25 J/cm subset required retreatment by 6 months.

CONCLUSION

Although the sample in this study was small, there was a dose-response trend toward better visual outcomes and fewer treatments in the group treated with IVT injection and reduced-fluence PDT. This study along with other previously reported work suggests that studies using PDT in combination treatment for CNV should consider adding a reduced-fluence PDT arm.

Authors+Show Affiliations

Department of Ophthalmology, University of Washington, Seattle, WA, USA.No affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

18536593

Citation

Singh, Christopher N., and David A. Saperstein. "Combination Treatment With Reduced-fluence Photodynamic Therapy and Intravitreal Injection of Triamcinolone for Subfoveal Choroidal Neovascularization in Macular Degeneration." Retina (Philadelphia, Pa.), vol. 28, no. 6, 2008, pp. 789-93.
Singh CN, Saperstein DA. Combination treatment with reduced-fluence photodynamic therapy and intravitreal injection of triamcinolone for subfoveal choroidal neovascularization in macular degeneration. Retina (Philadelphia, Pa). 2008;28(6):789-93.
Singh, C. N., & Saperstein, D. A. (2008). Combination treatment with reduced-fluence photodynamic therapy and intravitreal injection of triamcinolone for subfoveal choroidal neovascularization in macular degeneration. Retina (Philadelphia, Pa.), 28(6), 789-93. https://doi.org/10.1097/IAE.0b013e31817082d7
Singh CN, Saperstein DA. Combination Treatment With Reduced-fluence Photodynamic Therapy and Intravitreal Injection of Triamcinolone for Subfoveal Choroidal Neovascularization in Macular Degeneration. Retina (Philadelphia, Pa). 2008;28(6):789-93. PubMed PMID: 18536593.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Combination treatment with reduced-fluence photodynamic therapy and intravitreal injection of triamcinolone for subfoveal choroidal neovascularization in macular degeneration. AU - Singh,Christopher N, AU - Saperstein,David A, PY - 2008/6/10/pubmed PY - 2008/7/25/medline PY - 2008/6/10/entrez SP - 789 EP - 93 JF - Retina (Philadelphia, Pa.) JO - Retina (Philadelphia, Pa.) VL - 28 IS - 6 N2 - PURPOSE: To evaluate combination treatment with reduced-fluence photodynamic therapy (PDT) and intravitreal triamcinolone acetonide (IVT) injection for choroidal neovascularization (CNV) in age-related macular degeneration (AMD). METHODS: This is a retrospective consecutive case series of 23 previously untreated eyes of 22 patients with subfoveal CNV secondary to AMD. Six eyes were treated with 50 J/cm; 8, with 40 J/cm; and 9, with 25 J/cm. PDT was immediately followed by a 4-mg IVT injection. Patients were observed for 6 months at 6-week intervals. RESULTS: : The 50 J/cm subset lost a mean of 2.2 lines of Snellen visual acuity at the 6-month follow-up compared with a 1-line lost in the 40 J/cm subset and a 0.9-line gain in the 25 J/cm subset. In the 50 J/cm subset, 60% lost < or =3 lines of Snellen visual acuity, 33% gained > or =0 line, and 33% gained > or =3 lines. In the 40 J/cm subset, 75% lost < or =3 lines of Snellen visual acuity, 50% gained > or =0 line, and 25% gained > or =3 lines. In the 25 J/cm subset, 89% lost < or =3 lines of Snellen visual acuity, 56% gained > or =0 line, and 33% gained > or =3 lines. Fifty percent of the 50 J/cm subset, 50% of the 40 J/cm subset, and 33% of the 25 J/cm subset required retreatment by 6 months. CONCLUSION: Although the sample in this study was small, there was a dose-response trend toward better visual outcomes and fewer treatments in the group treated with IVT injection and reduced-fluence PDT. This study along with other previously reported work suggests that studies using PDT in combination treatment for CNV should consider adding a reduced-fluence PDT arm. SN - 0275-004X UR - https://www.unboundmedicine.com/medline/citation/18536593/Combination_treatment_with_reduced_fluence_photodynamic_therapy_and_intravitreal_injection_of_triamcinolone_for_subfoveal_choroidal_neovascularization_in_macular_degeneration_ L2 - http://dx.doi.org/10.1097/IAE.0b013e31817082d7 DB - PRIME DP - Unbound Medicine ER -