Skip to main content

Advertisement

SpringerLink
Log in

Optical coherence tomography analysis of a randomized study combining photodynamic therapy with intravitreal triamcinolone

  • Retinal Disorders
  • Published:
Graefe's Archive for Clinical and Experimental Ophthalmology Aims and scope Submit manuscript

Abstract

Background

The objective of the study was to analyze optical coherence tomography (OCT) scan differences between patients with predominantly classic subfoveal choroidal neovascularization (CNV) secondary to age-related macular degeneration (AMD) treated with only photodynamic therapy (PDT) and patients treated with PDT combined with intravitreal triamcinolone acetonide (IVTA).

Methods

In this prospective study, 61 patients were randomized to receive PDT (n = 30) or PDT combined with IVTA (n = 31). They were evaluated every 3 months with a refraction protocol for best-corrected visual acuity (VA) measured with Early Treatment Diabetic Retinopathy Study (ETDRS) charts, fluorescein angiography (FA), and OCT. When measuring foveal thickness on OCT scans, neuroretinal foveal thickness (NFT) was differentiated from outer high reflectivity band thickness (OHRBT). The main outcome measures were mean change in OCT measurements and correlation of VA and angiographic area of the lesion with OCT measurements.

Results

At the 12-month follow-up, the mean change in NFT was not significantly reduced (P = 0.9), but the mean change in OHRBT was significantly lower (P = 0.004) in the group of patients who received combined therapy. There was no correlation between final VA and NFT in either patient group (P = 0.2). The final VA was significantly worse in eyes with a thicker OHRBT (P = 0.04) in the group of patients treated with only PDT. There was no correlation between angiographic area and NFT and OHRBT in either patient group (P > 0.3). There was a statistically significant difference between the pre-treatment angiographic area of the lesion and VA at the 12-month follow-up in the combined therapy group (P = 0.01), and more eyes treated with only PDT presented with intraretinal fluid at the last follow-up (P = 0.01).

Conclusion

Combined PDT+IVTA therapy was more effective than PDT alone at reducing OHRBT. This OCT measurement seems to be have a greater effect on VA than NFT.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7
Fig. 8

Similar content being viewed by others

References

  1. Treatment of AMD with PDT Study Group (1999) Photodynamic therapy of subfoveal choroidal neovascularization in AMD with verteporfin: one-year results of 2 randomized clinical trials—TAP Report 1. Arch Ophthalmol 117:1329–1345

    Google Scholar 

  2. Spaide RF, Sorenson J, Maranan L (2005) Photodynamic therapy with verteporfin combined with intravitreal injection of triamcinolone acetonide for choroidal neovascularization. Ophthalmology 112:301–304

    Article  PubMed  Google Scholar 

  3. Verteporfin Roundtable Participants (2005) Guidelines for using verteporfin (Visudyne) in photodynamic therapy for choroidal neovascularization due to age-related macular degeneration and other causes: update. Retina 25:119–134

    Article  Google Scholar 

  4. Toth CA, Narayan DG, Boppart SA et al (1998) A comparison of retinal morphology viewed by optical coherence tomography and by light microscopy. Arch Ophthalmol 115:1425–1428

    Google Scholar 

  5. Montero JA, Ruiz-Moreno JM, Tavolato M (2003) Follow-up of age-related macular degeneration patients treated by photodynamic therapy with optical coherence tomography 3. Graefes Arch Clin Exp Ophthalmol 24:797–802

    Article  Google Scholar 

  6. Ozdemir H, Karacorlu SA, Karacorlu M (2006) Early optical coherence tomography changes after photodynamic therapy in patients with age-related macular degeneration. Am J Ophthalmol 141:574–576

    Article  PubMed  Google Scholar 

  7. Arias L, Garcia-Arumi J, Ramon JM et al (2006) Photodynamic therapy with intravitreal triamcinolone in predominantly classic choroidal neovascularization: one-year results of a randomized study. Ophthalmology 113:2243–2250

    Article  PubMed  Google Scholar 

  8. Sahni J, Stanga P, Wong D, Harding S (2005) Optical coherence tomography in photodynamic therapy for subfoveal choroidal neovascularisation secondary to age related macular degeneration: a cross sectional study. Br J Ophthalmol 89:316–320

    Article  PubMed  CAS  Google Scholar 

  9. Rogers AH, Martidis A, Greenberg PB, Puliafito CA (2002) Optical coherence tomography findings following photodynamic therapy of choroidal neovascularization. Am J Ophthalmol 134:566–576

    Article  PubMed  Google Scholar 

  10. Hughes EH, Khan J, Patel N, Kashani S, Chong NV (2005) In vivo demonstration of the anatomic differences between classic and occult choroidal neovascularization using optical coherence tomography. Am J Ophthalmol 139:344–346

    Article  PubMed  Google Scholar 

  11. Ray R, Stinnett SS, Jaffe GJ (2005) Evaluation of image artifact produced by optical coherence tomography of retinal pathology. Am J Ophthalmol 139:18–29

    Article  PubMed  Google Scholar 

  12. Sadda SR, Wu Z, Walsh AC et al (2006) Errors in retinal thickness measurements obtained by optical coherence tomography. Ophthalmology 113:285–293

    Article  PubMed  Google Scholar 

  13. Salinas-Alaman A, Garcia-Layana A, Maldonado MJ, Sainz-Gomez C, Alvarez-Vidal A (2005) Using optical coherence tomography to monitor photodynamic therapy in age related macular degeneration. Am J Ophthalmol 140:23–28

    PubMed  Google Scholar 

  14. Michels S, Aue A, Simader C, Geitzenauer W, Sacu S, Schmidt-Erfurth U (2006) Retinal pigment epithelium tears following verteporfin therapy combined with intravitreal triamcinolone. Am J Ophthalmol 141:396–398

    Article  PubMed  CAS  Google Scholar 

  15. Quaranta-El Maftouhi M, Mauget-Faysse M (2006) Anomalous vitreoretinal adhesions in patients with exudative age-related macular degeneration: an OCT study. Eur J Ophthalmol 16:134–137

    PubMed  CAS  Google Scholar 

  16. Witkin AJ, Duker JS (2005) Optical coherence tomography of the vitreomacular interface in photodynamic therapy. Br J Ophthalmol 89:929

    Article  PubMed  CAS  Google Scholar 

  17. Schmidt JC, Mennel S, Hörle S, Meyer CH (2006) High incidence of vitreomacular traction in recurrent choroidal neovascularization after repeated photodynamic therapy. Br J Ophthalmol 90:1361–1362

    Article  PubMed  CAS  Google Scholar 

  18. Mennel S, Liu F, Meyer CH (2005) Optical coherence tomography in photodynamic therapy. Br J Ophthalmol 89:928–929

    Article  PubMed  CAS  Google Scholar 

  19. Krebs I, Binder S, Stolba U et al (2005) Optical coherence tomography guided retreatment of photodynamic therapy. Br J Ophthalmol 89:1184–1187

    Article  PubMed  CAS  Google Scholar 

  20. Van de Moere A, Sandhu SS, Talks SJ (2006) Correlation of optical coherence tomography and fundus fluorescein angiography following photodynamic therapy for choroidal neovascular membranes. Br J Ophthalmol 90:304–306

    Article  PubMed  Google Scholar 

  21. Eter N, Spaide RF (2005) Comparison of fluorescein angiography and optical coherence tomography for patients with choroidal neovascularization after photodynamic therapy. Retina 25:691–696

    Article  PubMed  Google Scholar 

  22. Ting TD, Oh M, Cox TA, Meyer CH, Toth CA (2002) Decreased visual acuity associated with cystoid macular edema in neovascular age-related macular degeneration. Arch Ophthalmol 120:731–737

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Ophthalmology, Bellvitge University Hospital, C/Feixa Llarga, S/N. L’Hospitalet de Llobregat, 08907, Barcelona, Spain

    L. Arias, M. Rubio & O. Pujol

  2. Universitat Autonoma de Barcelona, Barcelona, Spain

    L. Arias

  3. Department of Ophthalmology, Vall d’Hebron University Hospital (Universitat Autonoma de Barcelona), Barcelona, Spain

    J. Garcia-Arumi

  4. Institut de Microcirurgia Ocular (IMO), Barcelona, Spain

    J. Garcia-Arumi

  5. Department of Preventive Medicine, Bellvitge University Hospital, Barcelona, Spain

    J. M. Ramon

  6. Department of Pharmacy, Bellvitge University Hospital, Barcelona, Spain

    M. Badia

Authors
  1. L. Arias
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. J. Garcia-Arumi
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. J. M. Ramon
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. M. Badia
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. M. Rubio
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. O. Pujol
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to L. Arias.

Additional information

The authors have no proprietary or financial interest in any aspect of this study.

The English editing of the manuscript has been revised by SciTechEdit International.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Arias, L., Garcia-Arumi, J., Ramon, J.M. et al. Optical coherence tomography analysis of a randomized study combining photodynamic therapy with intravitreal triamcinolone. Graefes Arch Clin Exp Ophthalmol 246, 245–254 (2008). https://doi.org/10.1007/s00417-007-0642-1

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00417-007-0642-1

Keywords

Search

Navigation