Long-term efficacy of transpupillary thermotherapy for subfoveal choroidal neovascularization in age-related macular degeneration / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To determine the long-term efficacy of transpupillary thermotherapy (TI-F) in the treatment of subfoveal choroidal neovascularization (CNV) in age-related macular degeneration (AMD).METHODS: Fourteen eyes of 14 patients with subfoveal CNV secondary to AMD were treated with diode laser (810nm) TTT. The mean age was 67.1 years. Complete ophthalmic examination was done, color fundus photographs and macular optical coherence tomography scans were taken, fluorescein and indocyanine green angiography were performed during initial and at subsequent follow-up examinations. Treatment was given in one minute using 2-3ram spot sizes, and laser power settings were between 650-800mW. The follow-up period was between 5 and 64 months and the mean was 28.6 months.RESULTS: There was subfoveal classic CNV in 10, predominantly classic CNV in 2, minimally classic CNV in 1, and type 1 occult CNV in one of the fourteen eyes. Four patients were noted to have post-treatment hemorrhage which was absorbed in a short time. Macular non-perfusion occurred in one patient immediately after treatment. Most of the eyes demonstrated a decrease in exudation during the follow-up. With a mean follow-up of 28.6 months, visual acuity improved in 5, remained the same in 8 and decreased in 1 of the 14 eyes.CONCLUSION: Transpupillary thermotherapy is shown to close subfoveal CNV with rapid resolution of subretinal fluid while maintaining visual function in patients with AMD. It may be performed as an alternative laser treatment in classic and predominantly classic subfoveal choroidal neovascularization due to AMD.

Photodynamic Therapy for Choroidal Neovascularization caused by Age-related Macular Degeneration (AMD)

PURPOSE: To evaluate the short-term results of photodynamic therapy with verteporfin for the patients with subfoveal CNV caused by age-related macular degeneration. METHODS: We performed photodynamic therapy with verteporfin in 21 patients (21 eyes) who were diagnosed as subfoveal CNV in AMD. The range of age was from 54 to 81, and 67 on average. Male patients were fifteen and female patients were six. The pretreatment visual acuity by ETDRS chart was from 20/200 to 20/32. On FAG, predominantly classic type were sixteen eyes, minimally classic type were four eyes, and no classic type was one eye. We followed up at 3 months intervals after treatment. The follow-up period was ranged from 3 months to 15 months, 6.8 months on average. We performed retreatment with the same method when any leakage was found on FAG performed every 3 months. RESULTS: One month after treatment, mean visual acuity change increased by 0.6 lines. Three months after treatment, mean visual acuity change increased by 0.8 lines. Six months after treatment, mean visual acuity change increased by 1.5 lines. Nine months after treatment, mean visual acuity change increased by 1.1 lines. On FAG, eight eyes showed minimal leakage, twelve eyes showed moderate leakage and only one eye showed progression after 3 months. Out of thirteen eyes which could be followed up more than 6 months, nine eyes showed minimal leakage, three eyes moderate leakage and only one eye progression. Out of nine eyes which could be followed up more than 9 months, five eyes showed minimal leakage, three eyes moderate leakage and only one eye progression. CONCLUSIONS: The above results indicate that the short-term results of photodynamic therapy for subfoveal CNV caused by AMD were encouraging as a good treatment modality to reduce the risk of visual loss. Further study with longer follow-up, a large number of cases and control study will be necessary to decide the effect of photodynamic therapy.

The Short-term Results of Photodynamic Therapy for Choroidal Neovascularization

PURPOSE: To evaluate the short-term results of photodynamic therapy with Verteporfin for the patients with choroidal neovascularization. METHODS: We performed photodynamic therapy with Verteporfin in 19 patients (19 eyes) who were diagnosed as subfoveal CNV. The range of age was from 27 to 81 years, and 57 years on average. Twelve patients were male and seven were female. The pretreatment visual acuity with ETDRS chart was from 20/200 to 20/32. On FAG, predominantly classic type were fourteen eyes, minimally classic were four eyes, and no classic was one eye. Visudyne(R) of 6 mg per body surface area was infused intravenously for 10 minutes, and then non-thermal diode laser of 689 nm wavelength was applied for 83 seconds with 600 Mw/Cm2 intensity. We followed up 1 month, 3 months after treatment, thereafter every 3 months. The follow up period was ranged from 3 months to 11 months, 4 months on average. We performed retreatment with the same method when any leakage was found on FAG which is performed every 3 month. RESULTS: Threes months after treatment, only one eye showed visual acuity decrease of more than 3 lines with ETDRS chart, and mean visual acuity change was increased by 0.94 lines. At the same time there was one eye which presented no leakage on FAG, seven eyes showed minimal leakage, ten eyes showed moderate leakage, and only one eye showed progression. Out of twelve eyes which could be followed up more than 6 months, only eye showed decreased visual acuity of more than 3 lines. On FAG, no leakage was not found, minimal leakage in nine eyes, moderate leakage in two eyes and one eye showed progression. CONCLUSION: The above results indicates that the short-term results of photodynamic therapy for subfoveal CNV from various causes were encouraging as a good treatment modality to reduce the risk of visual loss and further study with longer follow-up and large number of cases will be necessary to decide the effect of photodynamic therapy in Korea.