gms | German Medical Science

Since October 2001 over 450 photodynamic therapies (PDT) were performed in the Dept. of Ophthalmology at the Klinikum Hannover and over 100 transpupillary thermotherapies (TTT) in the Dept. of Ophthalmology at the Klinikum Braunschweig. This study was performed to investigate the results after PDT- and TTT-treatment of occult choroidal neovascularization (CNV) in exudative age-related macular degeneration (AMD).

For this study 64 eyes of 64 patients with occult CNV in AMD were included who were treated by PDT and 109 eyes of 104 patients who were treated by TTT between 11/01 and 09/03. PDT treatment parameters were according to the VIP study, TTT treatment modalities according to known criteria. The mean age of the patients at the time of first treatment was 73.5 years (59-89 years) and 77.5 years (55-94 years) respectively. The following parameters were examined at baseline and follow-up visits every 3 months: complete eye examination, Amsler test, and FAG- und ICG-AG. Re-treatment was performed only in those cases with angiographic findings and clinical deterioration. Size of leakage area was calculated by digital measurement in the late phase of the FAG. The mean follow-up after treatment was 10.5 months (6-31 months).

65 % of eyes after PDT and 72.4 eyes after TTT had a stable or increased visual acuity at the end of follow-up. In 73 - 80 % fluorescein leakage was reduced. Membrane size was reduced in 38.5 - 42 %. Stabilization or reduction of metamorphopsia was observed in 75 - 85%. The membrane size did not correlate with the final result. The mean number of PDT-treatments per case was 1.73 (range: 1-4), the number of TTT-treatments per case was 2.1 (range: 1-4).

PDT and TTT showed comparable results in this retrospective study. Re-treatment may not be mandatory if visual acuity and metamorphopsia are stable. A prospective controlled study is needed to further investigate these treatment modalities of occult CNV in exudative AMD.