Limited macular translocation compared with photodynamic therapy in the management of subfoveal choroidal neovascularization in age-related macular degeneration.
OBJECTIVE
To compare the visual outcome of macular translocation (MT) versus photodynamic therapy (PDT) for subfoveal predominantly classic neovascularization in age-related macular degeneration (AMD).


METHODS
Nonrandomized clinical trial.


METHODS
Retrospective review of 65 consecutive patients with subfoveal neovascularization due to AMD. The follow-up was at least 6 months. Main outcome criteria were final best corrected visual acuity and the gain in visual acuity.


RESULTS
A total of 29 eyes were treated with PDT with verteporfin, and 36 underwent MT with chorioscleral infolding. Both groups were similar for age, refraction, and lesion size. The initial visual acuity was lower in the MT group than in the PDT group (20/200 versus 20/100). Mean follow-up was 11 months for the PDT group and 14 months for the MT group. The mean displacement of the fovea after translocation was 1,274 microm (range, 250 to 1,900 microm). Mean number of retreatment by PDT was 2.5. At 1 year, both groups had the same final visual acuity (20/200), but the improvement was more favorable in the MT group (gain of 0.7 line in the MT group versus loss of 3.4 lines in the PDT group, P =.007). One eye in the PDT group (4.3%) had a gain of 3 lines or more versus eight eyes (38%) in the MT group; the lesion size was larger in the PDT group than in MT group (P =.036).


CONCLUSIONS
In this retrospective study, MT seemed to allow a better preservation of visual acuity than PDT in subfoveal neovascularization due to AMD. Further larger and controlled studies are required.
Pawlak
Dominique
D
University Eye Clinic of Créteil, Intercommunal and Henri Mondor (Assistance Publique des Hôpitaux de Paris) Hospitals, University of Paris XII, 40 avenue de Verdun, 94010 Créteil, France. dompawlak@aol.com
Glacet-Bernard
Agnès
A
Papp
Melitta
M
Roquet
Wilfried
W
Coscas
Gabriel
G
Soubrane
Gisele
G
D000368:Aged; D020256:Choroidal Neovascularization / Q000188:drug therapy* / Q000209:etiology / Q000601:surgery*; D005260:Female; D005451:Fluorescein Angiography; D005500:Follow-Up Studies; D005584:Fovea Centralis; D006801:Humans; D008266:Macula Lutea / Q000637:transplantation*; D008268:Macular Degeneration / Q000150:complications / Q000188:drug therapy* / Q000601:surgery*; D008297:Male; D010778:Photochemotherapy; D017319:Photosensitizing Agents / Q000627:therapeutic use; D011166:Porphyrins / Q000627:therapeutic use; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence; D000077362:Verteporfin; D014792:Visual Acuity / Q000502:physiology
D017319:Photosensitizing Agents; D011166:Porphyrins; D000077362:Verteporfin