Sequential combined therapy for treatment of choroidal neovascularization in age-related macular degeneration: photodynamic therapy and thermal laser photocoagulation.
OBJECTIVE
To analyze the results achieved after treating extrafoveal choroidal neovascularization (CNV) recurrences with thermal laser photocoagulation (TLP) in patients who had previously undergone photodynamic therapy (PDT).


METHODS
Seven eyes (seven patients: four women and three men) that had been initially treated by PDT for CNV associated with age-related macular degeneration (ARMD) and then developed extrafoveal recurrences were treated with green argon TLP. All patients underwent a complete ophthalmologic evaluation and fluorescein angiography. Mean age was 74.4 +/- 4.4 years (range, 69 to 81 years). Five right eyes and two left eyes were treated. Mean follow-up after the beginning of the treatment with PDT was 18.0 +/- 3.5 months (range, 11 to 22 months). Follow-up after TLP was 6.8 +/- 1.0 months (range, 6 to 8 months).


RESULTS
Mean best-corrected visual acuity (BCVA) before treatment was 20/150 (range 20/400 to 20/40). After PDT it was 20/281 (range, 20/400 to 20/80), with a mean of 3.1 +/- 0.8 treatments (range, 2 to 4). After TLP, BCVA was 20/233 (range, 20/400 to 20/80), with no statistically significant difference from BCVA after PDT (p = 0.06, Student's t-test paired data). In all cases total closure of CNV was achieved after only one session of TLP.


CONCLUSIONS
TLP could be helpful in association with multiple sessions of PDT in order to achieve a complete closure of subfoveal CNV secondary to ARMD. Further studies are required to confirm our findings.
Ruiz-Moreno
J M
JM
Department of Ophthalmology, Miguel Hernández University School of Medicine, Alicante, Spain. jm.ruiz@umh.es
Montero
J A
JA
D000368:Aged; D000369:Aged, 80 and over; D020256:Choroidal Neovascularization / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D017075:Laser Coagulation; D008297:Male; D010778:Photochemotherapy; D012008:Recurrence; D014792:Visual Acuity