Comparison of photodynamic therapy and transpupillary thermotherapy for subfoveal choroidal neovascularization due to age-related macular degeneration.
BACKGROUND
The purpose of this study was to compare photodynamic therapy (PDT) against subthreshold transpupillary thermotherapy (TTT) with a diode laser for subfoveal choroidal neovascularization secondary to age-related macular degeneration (AMD).


METHODS
Patients with subfoveal choroidal neovascularization secondary to AMD were offered PDT as an initial intervention. If they declined PDT, then TTT was offered.


RESULTS
We evaluated and followed 115 consecutive patients for an average of 1 year. The primary outcome measure was visual acuity, but the interventions were also compared on the basis of lesion size and angiographically determined lesion activity. Baseline comparisons between the 2 treatment groups showed significant differences in pretreatment visual acuity, lesion size, and lesion composition. Univariate analysis of outcomes demonstrated equivalence between the treatment groups in final lesion size, angiographic activity, and visual acuity. Multivariate analysis also demonstrated equivalence between the treatment groups in final visual acuity while controlling for age, pretreatment visual acuity, and lesion category. Predominantly classic lesions were associated with poorer visual outcomes.


CONCLUSIONS
The PDT and TTT groups were equivalent in terms of all outcome parameters evaluated.
Maberley
David A L
DA
Department of Ophthalmology, University of British Columbia, Vancouver, BC, Canada. crtg_vancouver@hotmail.com
Chew
Hall
H
Ma
Patrick
P
Chang
Angela
A
Hollands
Hussein
H
Maberley
Alan
A
D000368:Aged; D000369:Aged, 80 and over; D020256:Choroidal Neovascularization / Q000209:etiology / Q000473:pathology / Q000628:therapy*; D005260:Female; D005451:Fluorescein Angiography; D005500:Follow-Up Studies; D005584:Fovea Centralis / Q000473:pathology*; D005654:Fundus Oculi; D006801:Humans; D006979:Hyperthermia, Induced / Q000379:methods*; D008268:Macular Degeneration / Q000150:complications* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D010778:Photochemotherapy; D011680:Pupil; D012189:Retrospective Studies; D016896:Treatment Outcome