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Stefano Piermarocchi, MD; Mauro Sartore, MD; Giuseppe Lo Giudice, MD; Veronica Maritan, MD; Edoardo Midena, MD; Tatiana Segato, MD

Arch Ophthalmol. 2008;126(10):1367-1374.

Objective  To evaluate the long-term effect of intravitreal triamcinolone acetonide (IVT) treatment combined with photodynamic therapy (PDT) vs PDT alone for neovascular age-related macular degeneration.

Methods  Prospective randomized study. Eighty-four patients were enrolled to receive PDT (n = 41) or IVT treatment followed by PDT (n = 43) within approximately a 7- to 15-day interval. All patients were naive to treatment. At baseline and each follow-up visit at 3, 6, 12, and 24 months, measurement of best-corrected visual acuity (VA), fluorescein angiography, indocyanine green angiography, and optical coherence tomography were performed. Mean changes in VA and retreatment rate were considered as primary outcome indicators. Analysis of vascular choroidal changes documented by indocyanine green angiography and fundus autofluorescence measurements were also performed.

Results  Mean VA increased at 1 month of follow-up but decreased progressively by the 24-month point in both groups (P = .74). The retreatment rate was significantly lower (P < .001) in the combined therapy group. Choroidal hypoperfusion/nonperfusion (P < .001) and areas with decreased/absent fundus autofluorescence within the PDT spot area were significantly greater with combined therapy (P < .001).

Conclusions  Combination IVT treatment with PDT seemed to be more effective for managing neovascular age-related macular degeneration, but long-term analysis failed to demonstrate functional benefits.

Author Affiliations: Departments of Ophthalmology, University of Padova (Drs Piermarocchi, Sartore, Midena, and Segato) and S. Antonio Hospital, Padova (Dr Lo Giudice), and Conegliano Hospital, Conegliano (TV) (Dr Maritan), Italy.

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