Photodynamic Therapy Versus Combined Photodynamic Therapy - Intravitreal Triamcinolone Acetonide in Treatment of Subretinal Neovascular Membrane Associated with Age-related Macular Degeneration
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Original Article
VOLUME: 38 ISSUE: 2
P: 144 - 151
March 2008

Photodynamic Therapy Versus Combined Photodynamic Therapy - Intravitreal Triamcinolone Acetonide in Treatment of Subretinal Neovascular Membrane Associated with Age-related Macular Degeneration

Turk J Ophthalmol 2008;38(2):144-151
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Received Date: 15.01.2008
Accepted Date: 04.04.2008
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ABSTRACT

Conclusion:

Visual outcomes of PDT and combined PDT-IVTA in the treatment of SRNM were found similar at a mean follow up of 8.5 months. However, it should be kept in mind that retreatement rate is less in combined group.

Results:

The mean age was 72 years (range 52 to 85 years), and the mean follow-up period was 8.5 months (range 3 to 27 months). Of 64 eyes, 27 (42%) were classified as classic, 34 (53%) as occult and 3 (5%) as minimally classic. In 1 st group no significant change was noted between initial (1.04 ± 0.09, mean ± SEM) and final (1.05 ± 0.07) logMAR visual acuity (P= 0.80). Likewise, initial visual acuity (0.98 ± 0.08) did not improve in the 2nd group in last exa-mination (1.05 ± 0.15, P=0.60). Average PDT rate was 1.9 ± 0.1 in the 1st group, 1.4 ± 0.1 in the 2nd group (P=0.01).

Materials and Methods:

A total of 64 eyes of 51 patients with SRNM due to age related macular degeneration (AMD) were treated with PDT alone (1 st group, n=44) or combined PDT- 4 mg IVTA (2nd group, n=20). Functional outcome was evaluated by comparing visual acuitiy in both groups. LogMAR visual acuity was used for statistical analysis. Retreatment rates were also evaluated.

Purpose:

To evaluate the efficacy of ocular photodynamic therapy (PDT) and combined PDT-intravitreal triamcinolone acetonide (IVTA) in the treatment of subretinal neovascular membrane (SRNM) due to age-related macular degeneration (AMD) in terms of visual acu-ity changes and retreatment rates.

Keywords:
Photodynamic therapy, intravitreal triamcinolone, subretinal choroidal neovascular membrane, age-related macular degeneration

References

1
Bressler NM, Bressler SB, Fine SL. Neovascular (exudative) age-related macular degeneration. In Retina, Vol 3 Medical Retina. Ryan SJ.Eds. Philadelphia. Mosby comp. 2006;1075-1089.
2
Treatment of Age-related Macular Degeneration With Photodynamic Therapy (TAP) Study Group, Photodynamic therapy of subfoveal choroidal neovascularization in age-related macular degeneration with verteporfin: twoyear results of 2 randomized clinical trials. TAP report no. 2. Arch Ophthalmol 2001;119:198-207.
3
Sternberg P, Lewis H. Photodynamic therapy for age-related macular degeneration: acandid apprasial. Am J Ophthalmol 2004;137:483-485.
4
Ishibashi T, M iki K, Sorgente N, et al. Effects of intravitreal administration of steroids on experimental subretinal neovascularization in subhuman primate. Arch Ophthalmol 1985;103:708-711.
5
Gillies MC, Simpson JM, Lou W, et al. A randomized clinical trial of single dose of intravitreal triamcinolone acetonide for neovascular age-related macular degeneration: one-year results. Arch Ophthalmol 2003;121:667-673.
6
Spaide RF, Sorenson J, Maranan L. Combined photodynamic therapy with verteporfin and intravitreal triamcinolone acetonide for choroidal neovascularization. Am J Ophthalmol 2003;110:1517-1525.
7
Verteporfin in Photodynamic Therapy (VIP) Study Group. Photodynamic therapy of subfoveal choroidal eovascularization in age-related macular degeneration: two-year results of a randomized clinical trial including lesions with occult with no classic choroidal neovascularization. VIP report no. 2. Am J Ophthalmol 2001;131:541-560.
8
Verteporfin in Photodynamic Therapy (VIP) Study Group. Photodynamic therapy of subfoveal choroidal neovascularization in pathologic myopia: with verteporfin: Oneyear results of a randomized clinical trial. VIP report no.1. Ophthalmology 2001;108:841-852.
9
Krebs I, Binder S, Stolba U, et al. Choroidal neovascularization in pathologic myopia: three-year results after photodynamic therapy. Am J Ophtalmol 2005;140:416-425.
10
Verteporfin in Ocular Histoplasmosis (VOH) Study Group. Photodynamic therapy of subfoveal choroidal neovascularization with vertoporfin in ocular histoplasmosis syndrome one-year results of an uncontrolled, prospective case series. Ophthalmology 2002;109:1499-1505.
11
Karaçorlu M, Karaçorlu S, Bürümcek E, Özdemir H. Yaşa baglı makula dejenerasyonunda fotodinamik tedavi uygulamasının klasik koroid neovaskularizasyonlu olgular ile klasik+gizli koroid neovaskularizasyonlu olgulardaki 6 aylık takip sonuçları. Türk Oftalmoloji Gazetesi 2002; 32:832-837.
12
Karaçorlu S, Özdemir H, Karaçorlu M. Patolojik miyopiye baglı subfoveal koroid neovaskülarizasyonu olgularında fotodinamik tedavi. Türk Oftalmoloji Gazetesi 2002;32:769-774.
13
Karaçorlu M, Karaçorlu S, Özdemir H. Klasik koroid neovaskülarizasyonlu ve gizli koroid neovaskülerizasyonlu yaşa baglı makula dejenerasyonu olgularındaki fotodinamik tedavi uygulamasının 12 aylık takip sonuçları. Retina-Vitreus 2003;11:13-18.
14
Yetik H, Müftüoglu G, Akar S, ve ark. Oküler fotodinamik tedavide 24 aylık sonuçlarımız. Retina-Vitreus 2005;13:173-178.
15
Akar S. Koroid neovaskülarizasyonlarının tedavisinde fotodinamik tedavi. Retina-Vitreus 2005;13:9-12.
16
Sönmez K, Atmaca LS. Yaşa baglı makula dejeneresansı-nın tedavisinde yenilikler. Türkiye Klinikleri Cerrahi Tıp Bilimleri 2006;2:38-47.
17
Menteş J. Fotodinamik tedavi. Türkiye Klinikleri Cerrahi Tıp Bilimleri 2006;2:30-37.
18
Koçak N, Karahan E, Öner FH, ve ark. Anjioid streaks'e baglı gelişen koroid neovaskülarizasyonunda argon lazer fotokoagülasyon ve fotodinamik tedavi sonuçları. Retina- Vitreus 2006;14:263-268.
19
Altan T, Kapran Z, Yalçın O, ve ark. Yaşa baglı maküla dejenerasyonunda subfoveal koroidal neovaskülarizasyonun verteporfin ile fotodinamik tedavisinin orta ve uzun dönem sonuçları. Retina-Vitreus 2006;14:169-174.
20
Atsam N, Özmert E, Batıoglu F. Yaşa baglı maküla dejeneresanslı retinal anjiomatöz proliferasyon ve polipoidal koroidal vaskülopati olgularında fotodinamik/kombine tedavi sonuçları. Retina-Vitreus 2007;15:81-86.
21
Öner A, Özkırış A, Karaküçük S, ve ark. Fotodinamik tedavide 18 aylık sonuçlarımız. Erciyes Tıp Dergisi 2007;29:35-39.
22
Bardak Y, Çekiç O, Tıg Ş, Kendir F. Subfoveal koroid neovaskularizasyonlu yaşa baglı maküla dejenerasyonunda oküler fotodinamik tedavi sonuçlarımız. Türk Oftalmoloji Gazetesi 2007;37:447-452.
23
Ishibashi T, Hata Y, Yoshikawa H, et al. Expression of vascular endothelial growth factor in experimental choroidal neovascularization. Graefes Arch Clin Exp Ophthalmol 1997;235:159-167.
24
Cui JZ, Kimura H, Spee C, et al. Natural history of choroidal neovascularization induced by vascular endothelial growth factor in the primate. Graefes Arch Clin Exp Ophthalmol 2000;238:326-333.
25
Challa JK, Gillies MC, Penfold PL, et al. Exudative macular degeneration and intravitreal triamcinolone: 18 month follow-up. Aust N Z J Ophtalmol 1998;26:277- 281.
26
Gillies MC, Simson JM, Billson FA, et al. Safety of an intravitreal injection of triamcinolone: results from a randomized clinical trial. Arch Ophtalmol 2004;122:336-340.
27
Augustin AJ, Schmidt-Erfurth U. Vertoporfin therapy and triamcinolone acetonide: convergent modes of action for treatment of neovascular age related macular degeneration.Eur J Ophtalmology 2006;16:824-834.
28
Michels S, Schmidt-Erfurth U. Sequence of early vascular events after photodynamic therapy. Invest Ophthalmol Vis Sci 2003;44:2147-2154.
29
Schmidt-Erfurth U, Schlotzer-Schrehard U, Cursiefen C,et al. Influence of photodynamic therapy on expression of vascular endothelial growth factor (VEGF), VEGF receptor 3, and pigment epithelium-derived factor. Invest Ophthalmol Vis Sci 2003;44:4473-4480.
30
Ruiz-Moreno JM, Montero JA, Barile S, Zarbin MA. Photodynamic therapy and high-dose intravitreal triamcinolone to treat exudative age-related macular degeneration: 1-year outcome. Retina 2006;26:602-612.
31
Spaide RF, Sorenson J, Maranan L. Photodynamic therapy with verteporfin combined with intravitreal injection of triamcinolone acetonide for choroidal neovascularization. Ophthalmology 2005;112:301-304.
32
Augustin AJ, Schmidt-Erfurth U. Verteporfin and intravitreal triamcinolone acetonide combination therapy for occult choroidal neovascularization in age-related macular degeneration. Am J Ophthalmol 2006;141:638-645.
33
Ergun E, Maar N, Ansari-Shahrezaei S, et al. Photodynamic therapy with verteporfin and intravitreal triamcinolone acetonide in the treatment of neovascular age-related macular degeneration. Am J Ophthalmol 2006;142:10-16.
34
Kumar A, Sinha S, Kumar V. Visual acuity and contrast sensitivity outcomes in Indian eyes undergoing photodynamic therapy with intravitreal injection of triamcinolone acetonide in age-related macular degeneration. Indian Journal of Ophtalmolgy 2007;55:207-211.
35
Rechtman E, Danis RP, Pratt LM, Harris A. Intravitreal triamcinolone with photodynamic therapy for subfoveal choroidal neovascularisation in age related macular degeneration. Br J Ophthalmol 2004;88:344-347.