Clinical Study
Eye (2009) 23, 645–651; doi:10.1038/eye.2008.17; published online 22 February 2008
Photodynamic therapy combined with posterior subtenon triamcinolone acetonide injection in the treatment of choroidal neovascularization
Y-A Lee1, T-C Ho1, M-S Chen1, C-H Yang1 and C-M Yang1
1Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan
Correspondence: C-M Yang, Department of Ophthalmology, National Taiwan University Hospital and School of Medicine, National Taiwan University, No. 7 Chung-Shan South Road, Taipei 100, Taiwan. Tel: +886 2 23123456, ext. 5187; Fax: +886 2 23934420. E-mail: chungmay@ntu.edu.tw
Received 4 July 2007; Accepted 14 January 2008; Published online 22 February 2008.
Abstract
Purpose
To evaluate the therapeutic effect of photodynamic therapy (PDT) combined with posterior subtenon injection of triamcinolone acetonide (PSTA) in the treatment of choroidal neovascularization (CNV).
Methods
In this retrospective case–control study, treatment outcomes at 12 months of patients with CNV were reviewed. One hundred and two consecutive patients (102 eyes) with subfoveal CNV of various causes were included. Patients in the study group (n=46) received PDT followed within 2 days by 40 mg of PSTA. Patients in the control group (n=56) received PDT alone. Patients were retreated 3 months later or more if fluorescein angiography showed residual membrane leakage. Treatment outcomes were compared between the two groups and among different CNV subgroups.
Results
Gain in mean best-corrected visual acuity (BCVA) was significantly higher in the study group (+0.78 lines) than in the control group (-1.86 lines) (P<0.0001). The number of treatments within 1 year was significantly less in the study group (1.26 vs 1.63, P=0.008). The mean BCVA change for myopic CNV and age-related predominantly classic CNV subgroups was significantly higher in the study group (+2.82 vs -0.91 lines, P=0.0005 for myopic CNV; +0.6 vs -1.79 lines, P=0.01 for age-related predominantly classic CNV). The main side effect in the study group was increased intraocular pressure (8.7%).
Conclusion
Compared with PDT alone, PDT combined with PSTA has a better therapeutic effect for both myopic and age-related predominantly classic CNV; the myopic CNV subgroup shows the best response.
Keywords:
photodynamic therapy, triamcinolone acetonide, choroidal neovascularization, posterior subtenon injection
