Photodynamic Therapy Versus Combined Photodynamic Therapy - Intravitreal Triamcinolone Acetonide in Treatment of Subretinal Neovascular Membrane Associated with Age-related Macular Degeneration

Purpose: To evaluate the efficacy of ocular photodynamic therapy (PDT) and combined PDT-intravitreal triamcinolone acetonide (IVTA) in the treatment of subretinal neovascular membrane (SRNM) due to age-related macular degeneration (AMD) in terms of visual acuity changes and retreatment rates. Materials and Methods: A total of 64 eyes of 51 patients with SRNM due to age related macular degeneration (AMD) were treated with PDT alone (1st group, n=44) or combined PDT- 4 mg IVTA (2nd group, n=20). Functional outcome was evaluated by comparing visual acuitiy in both groups. LogMAR visual acuity was used for statistical analysis. Retreatment rates were also evaluated. Results: The mean age was 72 years (range 52 to 85 years), and the mean follow-up period was 8.5 months (range 3 to 27 months). Of 64 eyes, 27 (42%) were classified as classic, 34 (53%) as occult and 3 (5%) as minimally classic. In 1st group no significant change was noted between initial (1.04 +/- 0.09, mean +/- SEM) and final (1.05 +/- 0.07) logMAR visual acuity (P= 0.80). Likewise, initial visual acuity (0.98 +/- 0.08) did not improve in the 2nd group in last examination (1.05 +/- 0.15, P=0.60). Average PDT rate was 1.9 +/- 0.1 in the 1st group, 1.4 +/- 0.1 in the 2nd group (P= 0.01). Conclusion: Visual outcomes of PDT and combined PDT- IVTA in the treatment of SRNM were found similar at a mean follow up of 8.5 months. However, it should be kept in mind that retreatement rate is less in combined group.