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Retinal angiomatous proliferation: combined therapy of intravitreal triamcinolone acetonide and PDT versus PDT alone

  • Retinal Disorders
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Abstract

Background

The objective of the study was to investigate whether combined treatment with photodynamic therapy (PDT) and triamcinolone acetonide intravitreally applied is superior to PDT alone in eyes with retinal angiomatous proliferation (RAP).

Methods

Between July 2004 and June 2005 eyes with RAP in age-related macular degeneration were included in a prospective study and were treated with 4 mg of triamcinolone acetonide followed by PDT (group 1). Eyes with RAP treated with PDT alone before June 2004 were retrospectively reviewed (group 2). Distance visual acuity (VA) with Early Treatment Diabetic Retinopathy Study (ETDRS) charts, greatest diameter of the lesion (measured by fluorescein angiography), and retinal thickness (measured by optical coherence tomography) were performed at baseline and at 6 weeks, 3 months, 6 months and 12 months thereafter.

Results

Fifty-eight eyes in 58 patients were included: 27 eyes in the combined treatment group and 31 eyes in the PDT monotherapy group. The groups were comparable with regard to age, gender and RAP stage. VA decreased from 65.6 to 52.0 and from 60.7 to 44.0 letters, and lesion size increased from 3.2 mm to 3.5 mm and from 3.3 mm to 3.5 mm in the combined and monotherapy groups respectively. There was a trend towards a better outcome in the combined group. Significantly (p = 0.01) fewer complications occurred in the combined group (22.2%) than in the monotherapy group (54.8%).

Conclusion

No significant differences could be found in the time course of distance VA, retinal thickness, and lesion size between the PDT monotherapy group and the combined PDT and IVTA group. However, significantly fewer complications occurred in the combined treatment group. New therapeutic strategies might be required in RAP lesions, probably including therapy with anti-angiogenic agents.

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Authors and Affiliations

  1. Department of Ophthalmology, Ludwig Boltzmann Institute of Retinology and Biomicroscopic Laser Surgery, Rudolf Foundation Clinic, Juchgasse 25, 1030, Vienna, Austria

    Ilse Krebs, Katharina Krepler, Ulrike Stolba & Susanne Binder

  2. Institute for Medical Statistics, Vienna, Austria

    Alexandra Goll

Authors
  1. Ilse Krebs
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  2. Katharina Krepler
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  3. Ulrike Stolba
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  4. Alexandra Goll
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  5. Susanne Binder
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Correspondence to Ilse Krebs.

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None of the authors has a financial interest that is related to the manuscript.

The authors have full control of all primary data and they agree to allow Graefes Archive for Clinical and Experimental Ophthalmology to review their data upon request.

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Krebs, I., Krepler, K., Stolba, U. et al. Retinal angiomatous proliferation: combined therapy of intravitreal triamcinolone acetonide and PDT versus PDT alone. Graefes Arch Clin Exp Ophthalmol 246, 237–243 (2008). https://doi.org/10.1007/s00417-007-0651-0

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  • DOI: https://doi.org/10.1007/s00417-007-0651-0

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