Efficacy of photodynamic therapy associated with intravitreal triamcinolone to treat subfoveal choroidal neovascularization secondary to age related macular degeneration (VERTA study)

Abstract

Abstract Purpose To report the efficacy of photodynamic therapy with Visudyne (PDT) associated with two different concentrations of intravitreal triamcinolone (TA) to treat subfoveal choroidal neovascularization (CNV) secondary to age related macular degeneration (AMD). Methods Prospective, controlled, randomized, multicenter, phase IIIb clinical trial. Fifty five eyes from 55 patients presenting CNV secondary to AMD were randomized to be treated by PDT as monotherapy, PDT associated with 4mg TA or PDT associated with 20mg TA. Primary outcome measure was the average change in visual acuity at one year. Secondary outcome measures were the proportion of patients with severe vision loss (≥15 letters) at one year, the proportion of patients with moderate vision loss (<15 letters) and CNV activity as determined by fluorescein angiography at three month intervals, and the appearance of side effects. Results No statistically significant differences were observed for the average change in visual acuity and for the proportion of patients with severe vision loss at one year. The proportion of patients with moderate vision loss was higher among patients treated by PDT combined with 4mg TA at 3 and 6 months. The most frequent adverse events were increased intraocular pressure and retinal pigment epithelium detachment. Conclusion Combined treatment PDT‐4mg TA may increase the proportion of patients with moderate vision loss at month 3 and 6 compared with PDT monotherapy and combined PDT‐20mg TA.