ABSTRACT
OBJECTIVE: To determine the long-term effect of photodynamic therapy (PDT) with verteporfin for age-related macular degeneration (AMD) and non-AMD in Thailand and to compare with the Treatment of Age-Related Macular Degeneration with Photodynamic Therapy (TAP) and Verteporfin in Photodynamic Therapy (VIP) study. MATERIAL AND METHOD: The data of patients who received PDT between July 2003 and December 2004 and had completed two-year follow-up were prospectively reviewed. Treated eyes were classified into two main groups, the AMD (group 1) and non-AMD (group 2) groups. The AMD group was further divided into three subgroups, group 1A, AMD with subfoveal choroidal neovascularization (CNV) and TAP/VIP compatible if they followed the recommendation guidelines characteristics, group 1B, AMD with subfoveal CNV and TAP/VIP incompatible, and group 1C, AMD with non-subfoveal CNV. The main outcomes were visual acuity change, number of treatments and the comparison with the first year results. RESULTS: Of 56 eyes, 46 eyes (82.14%) had completed 24-month follow-up. Thirty-four eyes had CNV-related AMD and 12 eyes were non-AMD. At the 24-month follow-up, mean visual acuity change in group 1A, 1B, 1C were increased 0.25 (p = 0.13), 0.05 (p = 0.52), and 0.28 (p = 0.003), respectively. The total number of treatments in the first and second year was 1.8 and 0.1 in group 1A, 2.3 and 0.1 in group 1B, 1.5 and 0.25 in group 1C. CONCLUSION: PDT was effective in Thai patients for the two-year follow-up even if they were not compatible with TAP/VIP criteria. The treatment demonstrated stabilization or less visual loss in long-term results.
ABSTRACT
OBJECTIVE: To determine the pattern of functional and anatomical responses after intravitreal triamcinolone (IVTA) for macular edema in diabetic retinopathy, retinal vein occlusion, uveitis, and macular telangiectasia. MATERIAL AND METHOD: A Retrospective interventional study was carried out between January 2004 and July 2006. Thirty-eight eyes from 36 patients who had undergone an IVTA injection for macular edema from etiologies other than age-related macular degeneration (non-AMD macular edema) were included in the present study. Visual improvement and retinal thickness were the main outcomes. Potential complications, including increased intraocular pressure (IOP), intraocular bleeding, and postoperative endophthalmitis were also recorded. RESULTS: The mean pre-operative logarithm of Minimum Angle of Resolution (logMAR) visual acuity (VA) was 1.0 with an average macular thickness of 463.2 +/- 141.4 microns and mean IOP of 12.9 +/- 2.7 mmHg. The macular thickness rapidly decreased in the first week after an injection with a trough at two months (p < 0.001) and began to rise thereafter. The overall VA started to improve significantly at one month and lasted for two months. The IOP significantly increased from the mean baseline during the first two months in 31.6%, which could be controlled only by the medication. No other serious complications were observed. CONCLUSION: IVTA has the potential to improve both functional and anatomical outcomes in non-AMD macular edema. The decrease in macular thickness occurs from one week after an injection but the visual function improves more slowly and has a short-time effect.