Photodynamic therapy with verteporfin for subfoveal choroidal neovascularization in age-related macular degeneration: results of an effectiveness study.
OBJECTIVE
To determine the postapproval effectiveness of photodynamic therapy (PDT) with verteporfin for the treatment of predominantly classic subfoveal choroidal neovascularization (CNV) secondary to age-related macular degeneration.


METHODS
Forty-five consecutive patients treated with PDT for subfoveal CNV were compared with an untreated historical control group. Control patients had subfoveal CNV and were first seen by us within 1 year before Health Canada's approval of verteporfin. Both groups were followed up for the development of significant visual loss, stability, or improvement. Multivariate models were constructed to evaluate the effectiveness of PDT, controlling for multiple covariates (age, sex, baseline visual acuity, follow-up time, lesion size, and number of treatments).


RESULTS
Significant differences were noted in the change in visual acuity between those who did and did not receive PDT (chi(2) = 5.9, P =.048). Patients who received PDT were 2.9 times (95% confidence interval, 0.9-9.1) less likely to develop a moderate (>2 lines) visual loss (chi(2) = 3.2, P =.07). Controlling for covariates, patients who received PDT were 13.7 times (95% confidence interval, 1.4-132.6) more likely to develop a visual improvement of at least 1 line.


CONCLUSIONS
Compared with historical controls, PDT was demonstrated to be effective for the treatment of predominantly classic subfoveal CNV.
Sharma
Sanjay
S
Department of Epidemiology and Ophthalmology, Queen's University, and the Cost-Effective Ocular Health Policy Unit, Hotel Dieu Hospital, Kingston, Ontario. sanjay_sharma60@hotmail.com
Bakal
Jeff
J
Oliver-Fernandez
Alejandro
A
Blair
Jason
J
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D020256:Choroidal Neovascularization / Q000188:drug therapy* / Q000209:etiology; D005260:Female; D005584:Fovea Centralis / Q000187:drug effects; D006801:Humans; D008268:Macular Degeneration / Q000150:complications / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010778:Photochemotherapy; D017319:Photosensitizing Agents / Q000627:therapeutic use*; D011166:Porphyrins / Q000627:therapeutic use*; D016896:Treatment Outcome; D000077362:Verteporfin; D014792:Visual Acuity
D017319:Photosensitizing Agents; D011166:Porphyrins; D000077362:Verteporfin