COMBINED PHOTODYNAMIC THERAPY AND INTRAVITREAL TRIAMCINOLONE FOR CHOROIDAL NEOVASCULARIZATION SECONDARY TO PUNCTATE INNER CHOROIDOPATHY OR OF IDIOPATHIC ORIGIN

Abstract

To evaluate the efficacy and safety of combined intravitreal triamcinolone (IVTA) and photodynamic therapy (PDT) with verteporfin in the treatment of subfoveal choroidal neovascularization (CNV) due to punctate inner choroidopathy (PIC) or of idiopathic cause. Consecutive patients with subfoveal idiopathic and PIC CNV were prospectively recruited and received combined PDT and 4 mg IVTA injection. Patients were observed every 3 months for 1 year and retreatment was performed in the presence of angiographic leakage. Outcome measures included changes in the mean best-corrected visual acuity (BCVA), the proportion of patients who had stable or improved vision, and the mean number of treatments required during the 1-year period. Fourteen patients (14 eyes) were recruited and all completed the 1-year follow-up. The mean age of the patients was 34.7 years. The mean logMAR BCVA improved significantly from 0.52 at baseline to 0.20 at 1 year (Wilcoxon signed-ranks test, P = 0.003). For the entire group, 13 (92.9%) eyes had stable or improved vision with a mean improvement of 3.2 lines (range, -3-7 lines). The mean number of treatments during the 1-year study period was 1.1 sessions. No serious ocular or systemic complications were encountered. Combined PDT with IVTA seems to be a promising treatment strategy in the treatment of idiopathic CNV and CNV secondary to PIC as it resulted in fewer treatment sessions and superior visual improvement. Further study to assess its long-term safety and efficacy as the first line treatment is warranted.