Combined Transpupillary Thermotherapy with Subtenon Triamcinolone Injection in Treatment of Choroidal Neovascularization Secondary to Exudative Age Related Macular Degeneration

ABSTRACT: Introduction & Objective: In spite of several treatment methods which are being used to treat exudative age-related macular degeneration (ARMD) like laser therapy, Intravitreal steroids injections or anti-vascular endothelial growth factors (VEGF), no method has been yet presented as...

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Main Authors: M Naseripour, A Nikeghbali, A Vadipour, P Bakhtiari, A Ahadian
Format: Article
Language:fas
Published: Yasuj University Of Medical Sciences 2008-04-01
Series:Armaghane Danesh Bimonthly Journal
Subjects:
Online Access:http://armaghanj.yums.ac.ir/browse.php?a_code=A-10-39-3&slc_lang=en&sid=1
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author M Naseripour
A Nikeghbali
A Vadipour
P Bakhtiari
A Ahadian
author_facet M Naseripour
A Nikeghbali
A Vadipour
P Bakhtiari
A Ahadian
author_sort M Naseripour
collection DOAJ
description ABSTRACT: Introduction & Objective: In spite of several treatment methods which are being used to treat exudative age-related macular degeneration (ARMD) like laser therapy, Intravitreal steroids injections or anti-vascular endothelial growth factors (VEGF), no method has been yet presented as the best treatment way. This study aimed to assess the effectiveness of combined transpupillary thermotherapy (TTT) with subtenon triamcinolone acetonide (TA) injection in treatment of choroidal neovascularization (CNV) in patients with ARMD. Materials & Methods: In this clinical trial, 63 eyes of 57 patients with CNV secondary to exudative age-related macular degeneration (ARMD) were studied. All CNVs (including 20 predominantly classic and 43 predominantly occult lesions) were treated with diode laser (810nm). In 20 eyes with predominantly classic CNVs, 20 mg and 40 mg subtenon triamcinolone was injected in 12 and 8 eyes respectively. The patients were followed for a mean of 9.1 months (ranging from 5.5 to 16 months). The average number of treatment sessions was 1.25. In 43 eyes with occult CNV, 20 mg and 40 mg subtenon triamcinolone was injected in 31 eyes and in 12 eyes respectively. Mean follow up time was 12 months (4.5 to 23 months). Mean treatment times was 1.17. A variable spot size of 0.8, 1.2, 2 and 3 mm was used depending on the size of CNV and treatment was given in one area for 1 minute. Thermotherapy was adminstered through a contact lens at a power range between 120-560 mw. At the end of treatment, each patient randomly received 20 mg or 40 mg subtenon triamcinolone acetonide injection in superotemporal quadrant. Outcome was assessed with clinical and angiographic examination.collected data were analyzed by one-sample and paired –sample T test, using SPSS software. Results: At the end of the study in first group, visual acuity remained stable (0 to ± one line) in 14 out of 20 (70 %) of eyes, improved (> one line) in 2 of 20 (10 %) eyes and showed a decline (> one line worsening) in 4/20 (20 %) eyes. In second group thirty one eyes (72.1 %) had stable vision (± 1 line), 4 eyes (9.32 %) had better vision more than 1 line and 8 eyes (18.6 %) had more than 1 line decrease in vision. Conclusion: All CNVs were closed in last follow up. No statistically significant difference was found between two groups in clinical and functional with 20 mg and 40 mg injection of subtenon TA. Combined TTT and subtenon injection of TA in eyes with exudative ARMD can be an effective method to stabilize visual acuity of these patients.
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spelling doaj.art-118deadd35ca408abd64b908877ff5b02022-12-22T03:52:33ZfasYasuj University Of Medical SciencesArmaghane Danesh Bimonthly Journal1728-65061728-65142008-04-01131113Combined Transpupillary Thermotherapy with Subtenon Triamcinolone Injection in Treatment of Choroidal Neovascularization Secondary to Exudative Age Related Macular DegenerationM Naseripour0A Nikeghbali1A Vadipour2P Bakhtiari3A Ahadian4 ABSTRACT: Introduction & Objective: In spite of several treatment methods which are being used to treat exudative age-related macular degeneration (ARMD) like laser therapy, Intravitreal steroids injections or anti-vascular endothelial growth factors (VEGF), no method has been yet presented as the best treatment way. This study aimed to assess the effectiveness of combined transpupillary thermotherapy (TTT) with subtenon triamcinolone acetonide (TA) injection in treatment of choroidal neovascularization (CNV) in patients with ARMD. Materials & Methods: In this clinical trial, 63 eyes of 57 patients with CNV secondary to exudative age-related macular degeneration (ARMD) were studied. All CNVs (including 20 predominantly classic and 43 predominantly occult lesions) were treated with diode laser (810nm). In 20 eyes with predominantly classic CNVs, 20 mg and 40 mg subtenon triamcinolone was injected in 12 and 8 eyes respectively. The patients were followed for a mean of 9.1 months (ranging from 5.5 to 16 months). The average number of treatment sessions was 1.25. In 43 eyes with occult CNV, 20 mg and 40 mg subtenon triamcinolone was injected in 31 eyes and in 12 eyes respectively. Mean follow up time was 12 months (4.5 to 23 months). Mean treatment times was 1.17. A variable spot size of 0.8, 1.2, 2 and 3 mm was used depending on the size of CNV and treatment was given in one area for 1 minute. Thermotherapy was adminstered through a contact lens at a power range between 120-560 mw. At the end of treatment, each patient randomly received 20 mg or 40 mg subtenon triamcinolone acetonide injection in superotemporal quadrant. Outcome was assessed with clinical and angiographic examination.collected data were analyzed by one-sample and paired –sample T test, using SPSS software. Results: At the end of the study in first group, visual acuity remained stable (0 to ± one line) in 14 out of 20 (70 %) of eyes, improved (> one line) in 2 of 20 (10 %) eyes and showed a decline (> one line worsening) in 4/20 (20 %) eyes. In second group thirty one eyes (72.1 %) had stable vision (± 1 line), 4 eyes (9.32 %) had better vision more than 1 line and 8 eyes (18.6 %) had more than 1 line decrease in vision. Conclusion: All CNVs were closed in last follow up. No statistically significant difference was found between two groups in clinical and functional with 20 mg and 40 mg injection of subtenon TA. Combined TTT and subtenon injection of TA in eyes with exudative ARMD can be an effective method to stabilize visual acuity of these patients.http://armaghanj.yums.ac.ir/browse.php?a_code=A-10-39-3&slc_lang=en&sid=1KEYWORDS:Age Related Macular Degeneration Choroidal Neo-Vascularization Transpupillary Thermo-TherapySubtenon Triamcinolone Aacetonide
spellingShingle M Naseripour
A Nikeghbali
A Vadipour
P Bakhtiari
A Ahadian
Combined Transpupillary Thermotherapy with Subtenon Triamcinolone Injection in Treatment of Choroidal Neovascularization Secondary to Exudative Age Related Macular Degeneration
Armaghane Danesh Bimonthly Journal
KEYWORDS:Age Related Macular Degeneration
Choroidal Neo-Vascularization
Transpupillary Thermo-Therapy
Subtenon Triamcinolone Aacetonide
title Combined Transpupillary Thermotherapy with Subtenon Triamcinolone Injection in Treatment of Choroidal Neovascularization Secondary to Exudative Age Related Macular Degeneration
title_full Combined Transpupillary Thermotherapy with Subtenon Triamcinolone Injection in Treatment of Choroidal Neovascularization Secondary to Exudative Age Related Macular Degeneration
title_fullStr Combined Transpupillary Thermotherapy with Subtenon Triamcinolone Injection in Treatment of Choroidal Neovascularization Secondary to Exudative Age Related Macular Degeneration
title_full_unstemmed Combined Transpupillary Thermotherapy with Subtenon Triamcinolone Injection in Treatment of Choroidal Neovascularization Secondary to Exudative Age Related Macular Degeneration
title_short Combined Transpupillary Thermotherapy with Subtenon Triamcinolone Injection in Treatment of Choroidal Neovascularization Secondary to Exudative Age Related Macular Degeneration
title_sort combined transpupillary thermotherapy with subtenon triamcinolone injection in treatment of choroidal neovascularization secondary to exudative age related macular degeneration
topic KEYWORDS:Age Related Macular Degeneration
Choroidal Neo-Vascularization
Transpupillary Thermo-Therapy
Subtenon Triamcinolone Aacetonide
url http://armaghanj.yums.ac.ir/browse.php?a_code=A-10-39-3&slc_lang=en&sid=1
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