Noha Khater, (Cairo, Egypt), Hoda, MH Mostafa, MD (Cairo, Egypt), Mahmoud Soliman (Cairo, Egypt), Tamer Macky, MD (Cairo, Egypt)

PURPOSE:

To evaluate the outcomes of combined intravitreal triamcinolone (IVTA) and photodynamic therapy (PDT) in the treatment of subfoveal choroidal neovascularization (CNV) caused by age related macular degeneration (AMD) and myopia.

METHODS:

Fifteen eyes from 15 patients with subfoveal CNV caused by AMD (n=10) and myopia (n=5) were recruited, and treated with combined PDT with IVTA. IVTA was performed immediately after PDT as an outpatient procedure. The mean number of treatments, mean line of visual acuity changes, and proportion of patients without moderate visual loss at one year was recorded.

RESULTS:

All subfoveal CNV were classic or predominantly classic membranes with a size range of 480-2400 microns. At one year, 50% of patients had one treatment session; 5 AMD and 3 myopic patients with a mean treatment rate of 1.4. Fifty percent of patients had at least one line of visual improvement, 30% had stable visual acuity and 20% of patients developed moderate visual loss at 1 year. Subgroup analysis showed that PDT with IVTA is equally effective in preventing visual loss regardless of neither the aetiology (AMD or myopic patients) nor the size of the membrane. Thirty percent developed significant rise in intraocular pressures which was medically controlled.

CONCLUSION:

Combined PDT with IVTA appeared effective at 12 months for stabilization of vision with lower rates of retreatments compared with PDT monotherapy. Further randomised control trials might be justified to conclude the efficacy of PDT with IVTA.