A consecutive series of 84 white patients (84 eyes), 59 women (mean [SD] age, 67.6 [11.6] years) and 25 men (mean [SD] age, 73.6 [9.1] years), with clinical and angiographic evidence of CNV secondary to AMD were enrolled and randomly assigned either to combined IVT treatment and PDT (IVT-PDT group) or to the PDT-only regimen (PDT-only group). All patients signed a comprehensive consent form before entering the study. The study was approved by the University of Padova Human Research Ethics Committee and was performed in accordance with the tenets of the Declaration of Helsinki. According to the angiographic features of the CNV, patients of both groups were further divided into predominantly classic CNV, minimally classic or not classic CNV, and retinal angiomatous proliferation. Patients with any previous treatment of the CNV or other confounding ocular disease, such as diabetic retinopathy or retinal vein thrombosis, were excluded from this study. Patients with CNV secondary to pathological myopia, idiopathic or inflammatory CNV, or CNV secondary to angioid streaks were also excluded. Forty-three patients (IVT-PDT group) received an injection of IVT (Kenalog; Bristol-Myers Squibb, New York, New York) 7 to 15 days before PDT. Forty-one patients who received only PDT (PDT-only group) were used as controls. In both groups, PDT with verteporfin (Visudyne; Novartis AG, Basel, Switzerland) was performed according to standard parameters, as described previously by the TAP Study.7 Each patient in the IVT-PDT group received an intravitreal injection of 0.1 mL of 4 mg of triamcinolone acetonide (TA) under sterile conditions in an operating room following periocular preparation with 10% povidone/iodine (Betadine; Meda Pharma, Solna, Sweden) and a conjunctival flush with 5% povidone/iodine. All injections were applied inferotemporally at 4 mm from the limbus. Within 15 days (±5 days) after injection, they also received PDT with verteporfin. In the IVT-PDT group, topical antibiotics were given from 3 days before to 4 days after the injection of TA. Intraocular pressure was monitored 1 and 7 days after injection and monthly thereafter. Only those patients with an IOP higher than 24 mm Hg also received topical medication. Both groups were followed up for at least 24 months after the first treatment. At baseline, each patient underwent best-corrected VA (logMAR [logarithm of the minimum angle of resolution]) measurement with Early Treatment Diabetic Retinopathy Study charts, Goldman applanation tonometry, ophthalmoscopic examination, FA, indocyanine green (ICG) angiography with a scanning laser ophthalmoscope (Heidelberg Retinal Angiograph HRA II; Heidelberg Engineering, Heidelberg, Germany), and optical coherence tomography (OCT) (Stratus OCT 3; Zeiss Jena GmbH, Jena, Germany). These examinations were repeated at 3, 6, 12, and 24 months. Fluorescein and ICG angiograms and OCT were performed to estimate the activity of the CNV and were independently (and jointly, in the case of discrepancy) evaluated by 2 expert readers (S.P. and G.L.G.). From the third month on, whenever FA showed leakage and/or increased CNV size and an increase of at least 100 μm of the retinal thickness due to macular edema, subretinal fluid, or RPE detachment, PDT was repeated (additional treatments occurred no sooner than 3 months [±15 days] after the last PDT session). To avoid adverse effects related to possible overdosing, IVT treatment was repeated after a minimum 6-month interval, when needed. Main outcome variables were best-corrected VA at baseline and at 1, 3, 6, 12, and 24 months, number of retreatments with PDT, and adverse events. Indocyanine green angiography was also performed to investigate the choroidal vasculature within the treatment area and the patency of CNV. Single 30° images were taken in rapid sequence during the first minute after ICG infusion and subsequently during late phases at 2, 5, 10, and 20 minutes. Confocal ICG images from early and late series were analyzed prior to and at 3, 6, 12, and 24 months after treatment in all patients of both groups. Closure of 1 or more choroidal vessels of the Sattler and Haller layers within the PDT-irradiated area, as investigated by mid-phase ICG angiography, was considered evidence of choroidal hypoperfusion. At baseline and at the 24-month point, fundus autofluorescence (FAF) images, obtained with the Heidelberg Retinal Angiograph HRA II, were also analyzed. The Heidelberg Retinal Angiograph HRA II uses an argon blue laser light with a wavelength of 488 nm for excitation and a barrier filter with a cutoff at 500 nm to record FAF. Fundus autofluorescence images were produced using a 30° field-of-view mode. A series of digital images obtained and saved from each eye were averaged to reduce noise in order to produce the final FAF image. The distribution of FAF was evaluated at the site of the CNV, around the CNV, and outside the area affected by the CNV.