title: Two-year visual outcomes after photodynamic therapy in age-related macular degeneration patients with or without polypoidal choroidal vasculopathy lesions.
abstract: OBJECTIVE
  To describe the visual outcomes 2 years after photodynamic therapy in Japanese patients with age-related macular degeneration (AMD) with or without polypoidal choroidal vasculopathy (PCV) lesions.
  
  
  METHODS
  Sixty-three eyes of 63 consecutive patients with AMD or AMD + PCV who underwent photodynamic therapy were included in this study. Fluorescein and indocyanine green angiography were performed to diagnose AMD and AMD + PCV. Change in mean visual acuity and recurrence of active lesion during the follow-up period up to 2 years were assessed.
  
  
  RESULTS
  Patients with typical AMD maintained visual acuity for 2 years after photodynamic therapy. For patients with AMD + PCV, the visual acuity was maintained during the first year but started decreasing by 0.09 logarithm of the minimum angle of resolution units per 3 months (95% confidence intervals [CI], 0.06-0.14) after 1 year. Moreover, patients with AMD + PCV had 82% higher risk of a recurrence of active lesions for each increase in 3 months of follow-up time after 1 year; this suggested that the risk of recurrence had increased later in follow-up after 1 year. Recurrence of active PCV lesions and massive subretinal hemorrhages were the main reasons for the late worsening of visual acuity.
  
  
  CONCLUSIONS
  The visual acuity after photodynamic therapy in AMD patients was maintained for 2 years after the initial treatment. Patients with AMD + PCV had stable visual outcome within 1 year but not after 1 year; there are risks of late recurrences and massive hemorrhages after 1 year in patients with AMD + PCV.
authors.affiliation: Department of Ophthalmology and Visual Science, Yamagata University Faculty of Medicine, Yamagata, Japan.
authors.forename: Daijiro
authors.initials: D
authors.lastname: Tsuchiya
authors.forename: Teiko
authors.initials: T
authors.lastname: Yamamoto
authors.forename: Ryo
authors.initials: R
authors.lastname: Kawasaki
authors.forename: Hidetoshi
authors.initials: H
authors.lastname: Yamashita
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002829:Choroid / Q000098:blood supply*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008268:Macular Degeneration / Q000150:complications* / Q000188:drug therapy* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D016491:Peripheral Vascular Diseases / Q000150:complications* / Q000503:physiopathology; D010778:Photochemotherapy; D012008:Recurrence; D012166:Retinal Hemorrhage / Q000150:complications / Q000503:physiopathology; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome; D014792:Visual Acuity