Treatment of subfoveal choroidal neovascularization secondary to age related macular degeneration with single treatment of verteporfin photodynamic therapy: a safety and short-term outcome.

ABSTRACT

OBJECTIVE: To evaluate the short-term efficacy on visual outcome and safety of a single treatment of photodynamic therapy with verteporfin using the standard dosage regimen in patients with predominantly classic subfoveal choroidal neovascularization (CNV) from age related macular degeneration. DESIGN: Prospective, noncomparative, consecutive, interventional case series. SETTING: Department of Ophthalmology, Chulalongkorn University and Hospital, Bangkok, Thailand. PARTICIPANTS: Patients with subfoveal CNV caused by age related macular degeneration. METHOD: Standardized protocol refraction, visual acuity testing, complete ophthalmic examination, color photography, and fluorescein angiography were used to evaluate the effects of a single treatment of photodynamic therapy with verteporfin. Follow-up was planned through 3 months in all patients. RESULTS: A total of 39 eyes from 35 patients enrolled into the present study and have completed 3 months follow-up. The mean +/- SD logMAR BCVA at baseline was 0.76 +/- 0.48, equivalent to the Snellen BCVA of 20/114 (range, 20/40 to 20/1000). The mean +/- SD logMAR BCVA at the final 3-month visit was 0.55 +/- 0.37, which was a Snellen equivalent of 20/70 (range, 20/30 to 20/1000). The mean line of BCVA improvement was 2.1 lines. The improvement in BCVA at the 3-month follow-up was statistically significant (Wilcoxon signed-rank test, P = .043). No patient suffered moderate loss of vision or a loss of vision in 2 or more lines. None of the patients suffered severe visual threatening adverse events at the time of treatment and during the study period. CONCLUSIONS: The results of short-term visual outcome is encouraging; PDT is the least invasive treatment method currently available to achieve a stable or improved vision in AMD patients. PDT with verteporfin can lead to cessation of fluorescein leakage from CNV for up to 3 months, with stabilization or improvement of vision for 12 weeks. A randomized, controlled study in the near future would be beneficial to demonstrate the long-term results and efficacy in the treatment of CNV associated with AMD.