Photodynamic therapy with verteporfin for choroidal neovascularisations in clinical routine outside the TAP study. One- and two-year results including juxtafoveal and extrafoveal CNV.
BACKGROUND
The aim of this study was to analyse 1- and 2-year outcomes after photodynamic therapy (PDT) in clinical routine outside of the TAP [treatment of age-related macular degeneration (AMD) with PDT] study. We analysed the functional results, possible influencing factors and the rate of side effects.


METHODS
We analysed the medical records of 210 consecutive patients between 50 and 93 years of age (73+/-9 years) who had been treated with PDT for active > or =50% classic CNV resulting from AMD. Only patients with a minimum follow-up of 1 year (127) were included; 52 patients completed 2 years of follow-up. Juxta- and extrafoveal CNV were also analysed. Treatment was given in accordance with TAP parameters and regular follow-up examinations were performed with standardised ETDRS visual acuity (VA) measurements and fluorescein angiography.


RESULTS
In the subfoveal group, in 63.6% (70/110) a loss of VA > or =3 lines could be prevented after 1 year, and in 51.1% (23/45) after 2 years. An improvement of > or =1 line was found in 31.8% (1 year) and in 22.2% of eyes (2 years). Severe VA loss of > or =6 lines occurred in 10.9% of cases after 1 year and in 15.6% after 2 years. The mean change of VA was -1.7+/-3.4 lines (1 year) and -2.5+/-3.9 lines (2 years). For the group of CNV with juxta-/extrafoveal localisation, the mean change of VA was +0.8+/-2.5 lines after 1 year and +1.0+/-4.2 lines after 2 years. With regard to different CNV localisations, the results for juxta-/extrafoveal CNV are statistical significantly better (p=0.005 and p=0.035 after 1 and 2 years, respectively). A mean of 2.6 treatments were performed in the first year and 0.5 in the second year.


CONCLUSIONS
The results obtained in a single institution compare favourably with the results of the TAP study. The results regarding functional visual outcome could be obtained with a lower number of treatments in clinical practice. Juxta- and extrafoveal CNV showed significantly better results than a subfoveal localisation of the CNV. In this subgroup a mean improvement of VA could be obtained after 1 or 2 years.
Wachtlin
Joachim
J
Department of Ophthalmology, Campus Benjamin Franklin, Charité-Universitätsmedizin Berlin, Hindenburgdamm 30, 12200 Berlin, Germany. joachim.wachtlin@charite.de
Stroux
Andrea
A
Wehner
Andreas
A
Heimann
Heinrich
H
Foerster
Michael H
MH
D000368:Aged; D000369:Aged, 80 and over; D020256:Choroidal Neovascularization / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D005260:Female; D005451:Fluorescein Angiography; D005500:Follow-Up Studies; D006801:Humans; D008268:Macular Degeneration / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D010778:Photochemotherapy; D017319:Photosensitizing Agents / Q000009:adverse effects / Q000627:therapeutic use*; D011166:Porphyrins / Q000009:adverse effects / Q000627:therapeutic use*; D016896:Treatment Outcome; D000077362:Verteporfin; D014792:Visual Acuity / Q000502:physiology
D017319:Photosensitizing Agents; D011166:Porphyrins; D000077362:Verteporfin