title: One-year results of photodynamic therapy for small predominantly classic choroidal neovascular membranes secondary to age-related macular degeneration.
abstract: OBJECTIVE
  To determine the visual and angiographic outcomes of patients with small predominantly classic choroidal neovascular membranes (CNV) undergoing photodynamic therapy (PDT).
  
  
  METHODS
  The subjects were a cohort of patients with age-related predominantly classic CNV with lesion size of greatest linear diameter of 2000 microm or less treated with PDT. Lesion size and visual acuity were recorded at baseline and at 3-month intervals. Visual treatment failure was defined as either loss of at least 15 letters or visual acuity less than 35 letters on a modified Early Treatment Diabetic Retinopathy Study chart. Lesion treatment failure was defined as increase in greatest linear diameter (GLD) of at least 500 microm.
  
  
  RESULTS
  Twenty-five eyes of 25 patients were included. Visual treatment failure occurred in 16 and mean visual acuity dropped from 58 letters to 34 letters (p<0.0001). In 11 of these patients this occurred within the first 3 months. Lesion treatment failure occurred in 18 patients. Mean GLD increased from 1331 to 2935 microm (p<0.0001). Early growth of the lesion was associated with poor visual outcome with growth in GLD in the first 3 months of 310 microm in patients without eventual visual treatment failure and 1131 microm in patients with eventual visual failure (p=0.027).
  
  
  CONCLUSIONS
  Small predominantly classic lesions commonly cause visual deterioration if treated with PDT alone. In the first year over 50% may lose at least 15 letters or drop below 35 letters, with most visual loss occurring in the first 3 months. Visual loss is associated with early lesion growth.
authors.affiliation: Sussex Eye Hospital, Brighton and Sussex University Hospitals NHS Trust, Brighton, UK. EdRachie@btinternet.com
authors.forename: E
authors.initials: E
authors.lastname: Doyle
authors.forename: M
authors.initials: M
authors.lastname: Khanwala
authors.forename: S P
authors.initials: SP
authors.lastname: Shah
authors.forename: D G
authors.initials: DG
authors.lastname: Ong
authors.forename: A G
authors.initials: AG
authors.lastname: Casswell
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D020256:Choroidal Neovascularization / Q000188:drug therapy* / Q000209:etiology / Q000473:pathology; D005451:Fluorescein Angiography; D005500:Follow-Up Studies; D005654:Fundus Oculi; D006801:Humans; D008268:Macular Degeneration / Q000150:complications* / Q000473:pathology; D008875:Middle Aged; D010778:Photochemotherapy / Q000379:methods*; D017319:Photosensitizing Agents / Q000627:therapeutic use*; D011166:Porphyrins / Q000627:therapeutic use*; D011446:Prospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D000077362:Verteporfin; D014792:Visual Acuity
chemical_list: D017319:Photosensitizing Agents; D011166:Porphyrins; D000077362:Verteporfin