Clinical study of photodynamic therapy for age-related macular degeneration / 中华眼底病杂志

ABSTRACT

Objective To study the clinical results and safty of photodynamic therapy (PDT) after single and multi treatments of patients with subfoveal choroidal neovascularization (CNV) caused by wet age related macular degeneration (AMD). Methods From July, 2000 to July, 2001, 20 wet AMD patients (31 eyes) 47 88 years old (mean 68.2 years old) with best corrected visual acuity from FC/10 cm to 0.6 diagnosed through optic coherence tomography (OCT), fluorescein angiography (FFA) and indocyanine green angiography (ICGA) were treated with PDT. All cases were assigned to benzoporphyrin derivative mono acid (BPD) (6 mg per square meter of body surface area), administered via intravenous infusion of 30 ml over 10 minutes. Fifteen minutes after the start of the infusion, a laser light at 689 nm (Zeiss company, German) delivered 50 J/cm 2 at an intensity of 600 mW/cm 2 over 83 seconds on CNV. Visual acuity, photochrome of ocular fundus, OCT, FFA, ICGA were used to evaluate the effects of photodynamic therapy with BPD. Follow up of these patients was planned 1 2 week and every 3 month after PDT. Once the lesion area progressed, PDT was applied again. Tweenty cases (31 eyes) were followed up from 3 to 18 months (average 12 month).In 1 affected eye, PDT was applied fow 4 times, 4 eye for 2 times, and the other 26 eyes for 1 time. Results The visual acuity in 13 (41 9%) eyes was improved ( increase≥2 lines) after PDT. Stabilized (?1 line) in 17 (54 8%) eyes and decreased 2 lines (attributed to the recur of CNV ) in 1 (3 2%) eye. After PDT, the fundus haemorrhage and fluid leakage reduced. FFA and ICGA showed. cessation and obvious reduction of fluorescein leakage from CNV in all patients 2 weeks after photodynamic therapy, and retreatment decreased the leakage step by step. Fluorescein leakage from at least a portion of the CNV reappeared by 1 3 month after treatment in some cases. OCT also showed the reduction of the size of CNV, moreover, the edema of surrounding retina and choriodal and serous neural epithelial detachment recovered obviously. No side affect during and after PDT was noticed. Conclusions PDT with BPD can achieve short term effect on part or total cessation of fluorescein leakage from CNV without loss of vision or growth of classic CNV in patients with age related macular degeneration, retreatment of PDT was also effective.