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Combined triamcinolone acetonide-PDT may reduce number of re-treatments
Ophthalmology. 2009;116(11):2149-2157.
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Intravitreal triamcinolone acetonide combined with verteporfin photodynamic therapy in treating classic subfoveal choroidal neovascularization associated with age-related macular degeneration did not improve vision at 1 year, according to a study.
"Combination therapy, however, can reduce the number of [verteporfin PDT] treatments required by subjects who have predominantly classic CNV owing to AMD," the study authors said. "This reduced treatment quantity needs to be weighed against potential side effects."
The 2-year, randomized, multicenter, sham-controlled trial included 100 patients older than 50 years assigned to undergo PDT with Visudyne (verteporfin, Novartis, QLT) alone or combined with intravitreal triamcinolone acetonide. All patients received adjunctive full-fluence verteporfin PDT at baseline and were administered same-day 4-mg injections of intravitreal triamcinolone acetonide or sham intraocular injections.
Intravitreal triamcinolone acetonide or sham injections in combination with PDT were repeated at 3-month intervals if there was angiographic evidence of leakage.
Investigators used ETDRS charts to assess best corrected visual acuity at baseline before enrollment and at each 3-month visit. Vision examiners were masked. Number of letters gained or lost at 1 year was the primary outcome measure.
Study data showed that eyes treated with the combination therapy lost an average of 17 letters; eyes treated with verteporfin PDT alone lost an average of 20 letters. Patients who received the combination therapy required significantly fewer re-treatments than those who received verteporfin PDT alone.