Photodynamic therapy for age-related macular degeneration in a clinical setting: visual results and angiographic patterns

Axer-Siegel, Ruth; Ehrlich, Rita; Yassur, Yuval; Rosenblatt, Irit; Kramer, Michal; Priel, Ethan; Benjamini, Yoav; Weinberger, Dov

doi:10.1016/j.ajo.2003.08.009

« Previous Next »American Journal of Ophthalmology
Volume 137, Issue 2 , Pages 258-264, February 2004

Photodynamic therapy for age-related macular degeneration in a clinical setting: visual results and angiographic patterns☆

Ruth Axer-Siegel, MD
- Department of Ophthalmology, Rabin Medical Center, Beilinson, Petah Tiqva, Israel (R.A.-S., R.E., I.R., M.K., D.W.)
- Mor Institute for Medical Data, Bnei Brak, Israel (R.A.-S., Y.K., I.R., M.K., E.P., D.W.)
- Sackler Faculty of Medicine (R.A.-S., Y.K., D.W.), Tel Aviv University, Tel Aviv, Israel
- Inquiries to Ruth Axer-Siegel, MD, Department of Ophthalmology, Rabin Medical Center, Beilinson Campus, Petah Tiqva 49 100, Israel; fax: (+972) 3-921-9084
Rita Ehrlich, MD
- Department of Ophthalmology, Rabin Medical Center, Beilinson, Petah Tiqva, Israel (R.A.-S., R.E., I.R., M.K., D.W.)
Yuval Yassur, MD
- Mor Institute for Medical Data, Bnei Brak, Israel (R.A.-S., Y.K., I.R., M.K., E.P., D.W.)
- Sackler Faculty of Medicine (R.A.-S., Y.K., D.W.), Tel Aviv University, Tel Aviv, Israel
Irit Rosenblatt, MD
- Department of Ophthalmology, Rabin Medical Center, Beilinson, Petah Tiqva, Israel (R.A.-S., R.E., I.R., M.K., D.W.)
- Mor Institute for Medical Data, Bnei Brak, Israel (R.A.-S., Y.K., I.R., M.K., E.P., D.W.)
Michal Kramer, MD
- Department of Ophthalmology, Rabin Medical Center, Beilinson, Petah Tiqva, Israel (R.A.-S., R.E., I.R., M.K., D.W.)
- Mor Institute for Medical Data, Bnei Brak, Israel (R.A.-S., Y.K., I.R., M.K., E.P., D.W.)
Ethan Priel
- Mor Institute for Medical Data, Bnei Brak, Israel (R.A.-S., Y.K., I.R., M.K., E.P., D.W.)
Yoav Benjamini, PhD
- Department of Statistics, Sackler Faculty of Exact Sciences (Y.B.), Tel Aviv University, Tel Aviv, Israel
Dov Weinberger, MD
- Department of Ophthalmology, Rabin Medical Center, Beilinson, Petah Tiqva, Israel (R.A.-S., R.E., I.R., M.K., D.W.)
- Mor Institute for Medical Data, Bnei Brak, Israel (R.A.-S., Y.K., I.R., M.K., E.P., D.W.)
- Sackler Faculty of Medicine (R.A.-S., Y.K., D.W.), Tel Aviv University, Tel Aviv, Israel

Accepted 5 August 2003.

Abstract

Purpose

To evaluate the visual outcome of patients with subfoveal choroidal neovascularization due to age-related macular degeneration, who received photodynamic therapy (PTD) in a clinical setting and to identify potential predictive visual and angiographic factors.

Design

Interventional case series.

Methods

The study included 74 patients with subfoveal choroidal neovascularization who underwent PDT from January 2000 to March 2001 and completed at least 1 year follow-up. All patients received verteporfin PDT and were followed clinically, with fluorescein angiography (74 eyes), and with indocyanine green angiography (65 eyes). A review of the medical records and angiograms was performed.

Results

Mean follow-up was 15.6 months. Patients received a mean of 3.4 treatments per year. Sixty-six percent lost less than 3 Snellen lines of visual acuity. Three patients (4%) experienced profound visual acuity loss to finger counting. Final visual acuity was positively correlated with lesion size and visual acuity at presentation. Visual outcome was worse in the presence of cystoid macular edema. On indocyanine green angiography, a round hypofluorescent spot was seen at the site of the PDT, with maintenance of medium and large choroidal vessels.

Conclusion

Smaller lesion size and better visual acuity at presentation were good predictive signs, whereas cystoid macular edema was found to be a poor prognostic sign for visual outcome following PDT.