Changes in macular sensitivity after reduced fluence photodynamic therapy
combined with intravitreal triamcinolone.
Author(s): Dunavoelgyi R, Sacu S, Simader C, Pruente C, Schmidt-Erfurth U.
Affiliation(s): Department of Ophthalmology and Optometry, Medical University of Vienna, Austria.
Publication date & source: 2011, Acta Ophthalmol. , 89(2):166-71
PURPOSE: This study aimed to evaluate the course of macular sensitivity (MS)
following treatment with reduced fluence photodynamic therapy (RPDT) versus
standard photodynamic therapy (SPDT) in combination with intravitreal
triamcinolone acetonide (IVTA) in patients with neovascular age-related macular
degeneration, and to investigate the correlation between MS and angiographic
outcomes.
METHODS: Forty eyes in 40 patients were included in this prospective, randomized
clinical study. Group 1 patients received RPDT (n = 20, light dose of 25 J/cm(2)
at 300 mW/cm(2)); group 2 patients received SPDT (n = 20, light dose of 50
J/cm(2) at 600 mW/cm(2)). All patients received 4 mg IVTA administered on the
same day as RPDT or SPDT. Microperimetry, visual acuity testing (ETDRS) and
fluorescein angiography (FA) were performed at baseline, and at months 3, 6, 9
and 12. Main outcome parameters were mean differential light threshold (DLT), and
absolute and relative scotoma size.
RESULTS: Mean DLT decreased from 4.71 dB at baseline to 3.45 dB after 12 months
in the SPDT + IVTA group (mean decrease 1.26 dB; p > 0.05) and from 5.42 dB to
4.92 dB in the RPDT + IVTA group (mean decrease 0.5 dB; p > 0.05). Absolute and
relative scotoma sizes remained stable in both groups at 12 months (mean change 0
and -0.6 test-points; p > 0.05). Mean DLT values and absolute scotoma sizes
correlated well with early and late leakage areas in FA (r = -0.45 to -0.80, p <
0.02).
CONCLUSIONS: With regard to MS, RPDT + IVTA did not show significant benefits
over SPDT + IVTA at 12 months. Macular sensitivity correlated well with
angiographic outcomes.
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