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‘PDT-plus’ seems useful for all AMD lesion types, clinician says
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NEW YORK — A combination of photodynamic therapy with intravitreal triamcinolone is showing efficacy in the management of all subtypes of age-related macular degeneration, according to a clinician speaking here.
Jay S. Duker, MD, discussed early results with the combination, dubbed “PDT-plus,” here at the Ocular Surgery News Symposium. He said the technique consists of photodynamic therapy using Visudyne (verteporfin for injection, Novartis/QLT) followed immediately by an intravitreal injection of 4 mg of Kenalog (triamcinolone acetate, Bristol-Myers Squibb).
Dr. Duker noted that, despite the absence of data from randomized controlled trials, this technique is already widely performed in the United States, with nearly 50% of PDT treatments employing this combination.
In a 1-year, prospective, nonrandomized study published this year in Ophthalmology by Spaide et al, no significant side effects were noted in two groups of patients treated with PDT-plus, Dr. Duker said.
In one group in the study, patients who had never received PDT were immediately treated with the combination. In a second group, patients who had received PDT alone previously were treated with PDT-plus in the trial.
Dr. Duker said the never-before-treated group “gained about 2 lines” of visual acuity.
“Those who had received PDT in the past gained 0.4 lines,” he said.
In both groups, 1.2 treatments per eye were administered in the 1-year period.
Dr. Duker stressed that no conclusions can yet be made regarding efficacy or long-term safety of PDT plus, but he said that randomized trials are under way.