[Dynamic phototherapy: treatment and retreatment criteria].
Exudative age-related macular degeneration (ARMD) is benefiting at present from new therapeutic approaches. Randomized clinical trials have demonstrated the efficacy of photodynamic therapy (PDT) in stabilizing visual acuity at 3 years. The basis of PDT consists in activating a photosensitizer with an adapted laser wavelength. Functional results are obtained on the basis of a strict classification of type of the new vessels responsible for exudative ARMD, based on fluorescein angiography. Thus, subfoveal lesions, in the form of either predominantly classic (visible new vessels>50%) or occult choroidal neovascularization (CNV), are the only indication for this therapy. Classic juxtafoveal CNV, where laser photocoagulation thermal burns may extend into the foveola, may be an extension of the indication of PDT. The follow-up after PDT is based on fluorescein angiography findings. The extension and persistence of leakage from the CNV remains an indication for retreatment. Ongoing studies are evaluating a number of features in order to define the responder group and possibly simplify the retreatment indications.
Hôpitaux Universitaires de Genève, Clinique d'Ophtalmologie, Rue Alcide-Jentzer 22, 1211 Genève 14, Suisse. constantin.pournaras@hcuge.ch
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Pournaras
D020256:Choroidal Neovascularization / Q000175:diagnosis / Q000188:drug therapy*; D004311:Double-Blind Method; D005122:Exudates and Transudates; D005451:Fluorescein Angiography; D005500:Follow-Up Studies; D006801:Humans; D008268:Macular Degeneration / Q000175:diagnosis / Q000188:drug therapy*; D015337:Multicenter Studies as Topic; D010778:Photochemotherapy; D017319:Photosensitizing Agents / Q000008:administration & dosage; D010919:Placebos; D011166:Porphyrins / Q000008:administration & dosage; D016032:Randomized Controlled Trials as Topic; D012008:Recurrence; D013997:Time Factors; D000077362:Verteporfin; D014792:Visual Acuity
D017319:Photosensitizing Agents; D010919:Placebos; D011166:Porphyrins; D000077362:Verteporfin