Retinal pigment epithelium tears following verteporfin therapy combined with intravitreal triamcinolone

Am J Ophthalmol. 2006 Feb;141(2):396-398. doi: 10.1016/j.ajo.2005.08.046.

Abstract

Purpose: To detect patients with neovascular age-related macular degeneration (AMD) who experience retinal pigment epithelium tears after initial verteporfin therapy combined with intravitreal triamcinolone during early follow-up.

Design: Prospective interventional case series.

Methods: Forty-five consecutive patients with choroidal neovascularization (CNV) in AMD were treated with verteporfin therapy combined with 4 mg of intravitreal triamcinolone. Optical coherence tomography (OCT), visual acuity, and fluorescein angiography were performed.

Results: Two eyes with a predominantly classic CNV developed a retinal pigment epithelium tear. An early onset tear could be differentiated from a delayed onset tear. OCT showed an increased depth signal in areas of missing retinal pigment epithelium and a wavy, contracted, and elevated retinal pigment epithelium band.

Conclusions: Retinal pigment epithelium tears can occur despite adding intravitreal triamcinolone to verteporfin therapy. OCT shows characteristic changes in the evolution of retinal pigment epithelium tears after combination therapy.

MeSH terms

  • Choroidal Neovascularization / drug therapy
  • Choroidal Neovascularization / etiology
  • Drug Therapy, Combination
  • Fluorescein Angiography
  • Glucocorticoids / adverse effects*
  • Glucocorticoids / therapeutic use
  • Humans
  • Injections
  • Macular Degeneration / complications
  • Macular Degeneration / drug therapy
  • Photochemotherapy
  • Photosensitizing Agents / adverse effects*
  • Photosensitizing Agents / therapeutic use
  • Pigment Epithelium of Eye / drug effects*
  • Porphyrins / adverse effects*
  • Porphyrins / therapeutic use
  • Prospective Studies
  • Retinal Perforations / chemically induced*
  • Tomography, Optical Coherence
  • Triamcinolone Acetonide / adverse effects*
  • Triamcinolone Acetonide / therapeutic use
  • Verteporfin
  • Visual Acuity
  • Vitreous Body

Substances

  • Glucocorticoids
  • Photosensitizing Agents
  • Porphyrins
  • Verteporfin
  • Triamcinolone Acetonide