http://www.evrs.eu/medias/2005/congress/One-year-results-of-photodynamic-therapy-in-eyes-with-choroidal-neovascular-membranes-due-to-age-related-macular-degeneration.swf

Tugrul Altan, Ziya Kapran, Mehmet Cakir, Nur Acar, Yaprak B. Unver, Zerrin Bayraktar

Purpose:

To evaluate the effectiveness of photodynamic therapy with verteporfin in preserving vision at 1 year in eyes with CNVM due to ARMD.

Methods:

44 eyes of 43 patients who had photodynamic therapy (PDT) with verteporfin for age related macular degeneration between December 2002 and January 2004 were included in the study. 29 (67%) women, 14 (33%) men, mean age was 70,3±6,4. Mean follow-up was 12,9±6,5 months.

Results:

Patients with choroidal neovascular membranes of less than 5400 microns, and membranes comprising more than 50% of the total lesion area were treated. Membrane localization was subfoveal in 37 (90,5%) eyes, juxtafoveal in 4 (9,1%). Membrane type was pure classic in 14 (31,8%) eyes, predominantly classic in 15 (34,1%), occult in 10 (22,7%) eyes, and minimally classic in 3 (6,8%) eyes. Mean preoperative best corrected visual acuity was (BCVA) 0,19±0,19 (logMAR 0,88±0,38), the number of PDT was 2,52±1,66. In 20 (45,5%) eyes BCVA was preserved at one year, 12 (27,3%) eyes had moderate vision loss, 2 (4,6%) had severe vision loss and 5 (11,4%) eyes that were lost to follow up were also considered to have severe vision loss (total 7 eyes 15,9%). 4 (9,1%) gained more than 3 lines, and 1 (2,3%) eye gained more than 6 lines. Mean BCVA at the last visit was 0,20±0,23 (logMAR 0,93±0,43). No change in contrast sensitivity at one year was detected. Greatest linear diameter of the lesion increased from 3059±1336 microns to 3438±1255 at the last visit. Four (9,5%) patients reported back pain during infusion and 2 (4,5%) patients had visual loss with spontaneous recovery in 1 week.

Conclusion:

PDT is a safe and considerably effective method of preserving vision at 1 year in eyes with CNVM due to ARMD.

Take-home message:

PDT is a safe method but it is not satisfactory. Its combination with other therapies may increase the effectiveness in preserving and improving visual function.