Laser treatments with verteporfin therapy and its potential impact on retinal practices.
BACKGROUND
In the 1990s, the only available treatment for neovascular age-related macular degeneration (ARMD) was laser photocoagulation, but a minority of patients could be treated. Photodynamic therapy with verteporfin potentially allows many more patients to be treated. The authors' aim was to assess the impact of this increase on retinal practices.


METHODS
The number of patients who received laser photocoagulation in 1998 was determined. Based on that number and a retrospective review of 1000 consecutive records of new patients with ARMD referred to the Associated Retinal Consultants practices during 1998, estimates were made of how many patients would have been eligible for verteporfin therapy.


RESULTS
Of the 1000 patients, 171 had predominantly classic subfoveal choroidal neovascularization secondary to ARMD and would have been eligible for verteporfin therapy, compared with 99 treated with laser photocoagulation according to Macular Photocoagulation Study guidelines. If this patient population is representative of the general population, approximately 84,000 patients would be eligible for verteporfin therapy in the United States per year, compared with 42,000 for laser photocoagulation. This would lead to 286,000 verteporfin treatments per year if retreatments are required.


CONCLUSIONS
This increase in treatments for neovascular ARMD will have a considerable impact on retinal practices. Although the resources that will need to be expended are high, the potential benefit of verteporfin therapy in reducing vision loss will outweigh the costs.
Margherio
R R
RR
Beaumont Eye Institute, Associated Retinal Consultants, PC, Royal Oak, Michigan 48073, USA. margherio@beaumont.edu
Margherio
A R
AR
DeSantis
M E
ME
D020256:Choroidal Neovascularization / Q000188:drug therapy* / Q000191:economics / Q000209:etiology; D003362:Cost-Benefit Analysis; D006801:Humans; D007275:Injections, Intravenous; D017075:Laser Coagulation; D008268:Macular Degeneration / Q000150:complications / Q000188:drug therapy* / Q000191:economics; D009885:Ophthalmology / Q000706:statistics & numerical data*; D010778:Photochemotherapy / Q000191:economics; D017319:Photosensitizing Agents / Q000191:economics / Q000627:therapeutic use*; D011166:Porphyrins / Q000191:economics / Q000627:therapeutic use*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D018434:Sickness Impact Profile; D000077362:Verteporfin; D014792:Visual Acuity
D017319:Photosensitizing Agents; D011166:Porphyrins; D000077362:Verteporfin