Prolongation of choroidal hypofluorescence following combined verteporfin photodynamic therapy and intravitreal triamcinolone acetonide injection.

Purpose: To determine the incidence and effect of persistent/prolonged choroidal hypofluorescence (PCH) following combined verteporfin photodynamic therapy and intravitreal triamcinolone acetate injection (PDT + IVTA) for age-related subfoveal choroidal neovascularization (CNVM).

Method: A retrospective review of all patients undergoing PDT + IVTA for CNVM from December 2003 through November 2004 was performed. Included patients underwent intravenous fundus fluorescein angiography (FA) preoperatively and 1 week and 3 months following PDT. FA presence of persistent choroidal hypofluorescence (PCH) 3 months postoperatively was graded in each eye by comparison with the 1 week postoperative FA. Twenty-seven eyes treated with PDT alone before December 2003 served as controls.

Results: A total of 53 eyes of 46 patients were identified for study. At 3 months post treatment, PCH was noted in 37/53 eyes (70%) receiving PDT + IVTA combination therapy compared to only 3/27 (11%) control eyes treated with PDT alone (P<0.0001; Fisher two-tailed exact test).

Conclusion: The findings suggest that IVTA prolongs the native PDT effect manifest by post treatment FA CH. This phenomenon may reflect a mechanism by which IVTA enhances the effectiveness of PDT. Further study is necessary to confirm and elucidate this possible association.