Vision-related function after low-dose transpupillary thermotherapy versus photodynamic therapy for neovascular age-related macular degeneration.
OBJECTIVE
To compare the effects of low-dose transpupillary thermotherapy (TTT) and verteporfin photodynamic therapy (PDT) on patient-reported visual function using the National Eye Institute Visual Function Questionnaire 25 (NEI VFQ-25) in patients with occult neovascular age-related macular degeneration (AMD).


METHODS
Patients were randomized to receive either low-dose TTT (and sham PDT) (n = 52) or PDT (and sham TTT) (n = 46). Patients were followed for 12 months with retreatment according to clinical assessment. The clinical outcome of this study has been recently reported. The NEI VFQ-25 questionnaire was administered at baseline and at 12 months.


RESULTS
Forty-two patients (80.1%) in the TTT group and 37 patients (80.0%) in the PDT group completed the questionnaire at the 12-month follow-up. The mean change in the NEI VFQ-25 composite score was +1.2 for the TTT group (p > 0.05) and +0.7 for PDT group (p > 0.05). None of the subscale categories showed significant changes between treatment groups at 12 months. Subgroup analysis showed that NEI VFQ-25 scores were lower in patients treated in their better-seeing eye.


CONCLUSIONS
In this randomized study on patients with occult neovascular AMD, low-dose TTT and PDT appeared to be equally potent at stabilizing patient-reported visual function. However, the study was underpowered for this conclusion to be made firmly. Also, given the impressive results obtained with ranibizumab for all types of neovascular AMD, neither PDT nor low-dose TTT should be considered as first-line treatments.
Odergren
Anne
A
Vitreoretinal Department, Karolinska Institute, St Erik's Eye Hospital, Stockholm, Sweden. anne.odergren@sankterik.se
Algvere
Peep V
PV
Seregard
Stefan
S
Libert
Carina
C
Kvanta
Anders
A
D020256:Choroidal Neovascularization / Q000188:drug therapy / Q000503:physiopathology / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006979:Hyperthermia, Induced; D008268:Macular Degeneration / Q000188:drug therapy / Q000503:physiopathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010778:Photochemotherapy; D017319:Photosensitizing Agents / Q000627:therapeutic use; D011166:Porphyrins / Q000627:therapeutic use; D011446:Prospective Studies; D011680:Pupil; D018434:Sickness Impact Profile; D011795:Surveys and Questionnaires; D000077362:Verteporfin; D014792:Visual Acuity / Q000502:physiology*
D017319:Photosensitizing Agents; D011166:Porphyrins; D000077362:Verteporfin