Follow-up after intravitreal triamcinolone acetonide for exudative age-related macular degeneration

Abstract

Purpose To report on the follow-up of patients who received an intravitreal triamcinolone acetonide injection (IVTA) as treatment of exudative age-related macular degeneration.Methods The clinical interventional caseseries study included 205 patients (222 eyes) with progressive exudative age-related macular degeneration with subfoveal neovascularization who consecutively received an IVTA of about 20 mg as only therapeutic procedure and for whom follow-up was at least 3 months. Mean follow-up was 10.477.1 months (range, 3-35.7 months). Results Visual acuity improved significantly (Po0.001) from baseline (0.9070.45 logarithm of the minimum angle of resolution (LogMar)) to a mean minimum of 0.7970.42 LogMar during follow-up. In 86 (38.7%) eyes and in 55 (24.8%) eyes, best visual acuity increased by at least two and three Snellen lines, respectively. Comparing the measurements at specific postinjection examination dates showed that visual acuity measurements taken at 1, 2, and 3 months after injection were not significantly different from the baseline value. Measurements taken at 6, 9, and 12 months after the injection were significantly (Po0.001) lower than the measurements at baseline. Mean loss at 6 months was 1.473.8 Snellen lines, at 9 months, 2.574.6 lines, and at 12 months after the injection, 2.674.0 lines. Intraocular pressure increased significantly (Po0.001) during the first 6 months, and returned to baseline at 9 months after injection.Conclusions Single injection high-dosage IVTA did not show an apparent benefit at 12 months after injection in patients with neovascular age-related macular degeneration.

Intravitreal Triamcinolone

“…Although there were differences between the studies in the type of subfoveal neovascularization, the dosage of TA, and the timing of the follow-up examinations, the randomized controlled study by Gillies et al [123] may be a landmark study cautioning against the use of TA as a monotherapy for exudative AMD. In agreement with Gillies et al [123], a recent follow-up study on 205 patients who received IVTA as a monotherapy for the treatment of exudative AMD reported that visual acuity at 6, 9 and 12 months after the injection was significantly (p < 0.001) lower than visual acuity at the baseline of the study [136]. The mean loss at 6 months was 1.4 ± 3.8 Snellen lines, at 9 months it was 2.5 ± 4.6 lines, and at 12 months after the injection it was 2.6 ± 4.0 lines.…”

“…IVTA has been discussed to be a possibly useful adjunct to the therapy of exudative AMD [116,117,118,119,120,121,122,123,124,125,126,127,128,129,130,131,132,133,134,135,136,137,138,139,140,141,142,143,144,145,146,147,148,149,150,151,152] since previous studies had shown that TA may have an antiangiogenic and antiedematous effect [112,113,114,115,258,259,260,262,263,264,265,266]. Both neovascularization and retinal edema are characteristics of exudative AMD.…”

Intravitreal Triamcinolone Acetonide: A Change in a Paradigm

“…In agreement with Gillies et al, a recent follow-up study on 205 patients who received intravitreal triamcinolone as monotherapy for the treatment of exudative age-related macular degeneration reported that visual acuity at 6 months, 9 months and at 12 months after the injection was significantly (p ! 0.001) lower than visual acuity at baseline of the study [137] . Mean loss at 6 months was 1.4 8 3.8 Snellen lines, at 9 months, 2.5 8 4.6 lines, and at 12 months after the injection, 2.6 8 4.0 lines.…”

Ocular Photodynamic Therapy – Standard Applications and New Indications (Part 2)

“…Intravitreal triamcinolone as a monotherapy of a single injection of a high dosage (20 mg) did not show an apparent benefit at 12 months after injection in patients with neovascular AMD [57], whereas combined IVTA and PDT showed even better results than PDT as a single procedure. Chan et al [58] compared 24 eyes that were treated with combined PDT with IVTA to a control group of 24 eyes which received PDT as a monotherapy and found the combined treatment regimen statistically more effective at 12 months for stabilization of vision.…”