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Profound choroidal hypoperfusion after combined photodynamic therapy and intravitreal triamcinolone acetonide
Gregory R Blaha1, F Denton Wertz, Jeffrey L Marx
1Vitreoretinal Surgery, Department of Ophthalmology, Lahey Clinic, Peabody, Massachusetts 01960, USA.
Background And Objective:
To report a case series of patients with profound choroidal hypoperfusion on fluorescein angiography following combined photodynamic therapy (PDT) and intravitreal triamcinolone acetonide (IVT) for age-related macular degeneration.
Patients And Methods:
A retrospective chart review was performed of all 108 patients (155 treatments) who had combined PDT/IVT between January 2002 and December 2004 at the institution.
Results:
Fifteen patients were identified with "profound choroidal hypoperfusion." There were no common risk factors identified. Hypoperfusion occurred in some patients after their initial treatment, whereas in others it developed only after repeated treatments. Two patients had severe vision loss associated with profound choroidal hypoperfusion.
Conclusions:
Profound choroidal hypoperfusion can be seen after combined therapy with PDT/ IVT. Although adding triamcinolone acetonide to PDT may improve efficacy, it may also change the side effect profile and severe vision loss may occur. Changes in treatment parameters may improve combined therapy.
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