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Photodynamic therapy with verteporfin for choroidal neovascularisations in clinical routine outside the TAP study. One- and two-year results including juxtafoveal and extrafoveal CNV.

Wachtlin J, Stroux A, Wehner A, Heimann H, Foerster MH

Department of Ophthalmology, Campus Benjamin Franklin, Charité-Universitätsmedizin Berlin, Hindenburgdamm 30, 12200 Berlin, Germany. joachim.wachtlin@charite.de

INTRODUCTION: 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.

Published 2 June 2005 in Graefes Arch Clin Exp Ophthalmol, 243(5): 438-45.
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