Artikel
PDT with Verteporfin for CNV due AMD beyond the TAP study. Results after one and two years
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Autoren
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J. Wachtlin
- Augenklinik, Campus Benjamin Franklin, Charité, Universitätsmedizin Berlin, Berlin
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A. Stroux
- Bereich Biometrie und Klinische Epidemiologie, Campus Benjamin Franklin, Charité, Universitätsmedizin Berlin, Berlin
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A. Wehner
- Augenklinik, Campus Benjamin Franklin, Charité, Universitätsmedizin Berlin, Berlin
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H. Heimann
- Augenklinik, Campus Benjamin Franklin, Charité, Universitätsmedizin Berlin, Berlin
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M. H. Foerster
- Augenklinik, Campus Benjamin Franklin, Charité, Universitätsmedizin Berlin, Berlin
| Veröffentlicht: | 22. September 2004 |
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Gliederung
Text
Objective
The large (TAP/VIP) randomized studies have revealed a positive effect of Photodynamic Therapy (PDT) for subfoveal choroidal neovascularizations (CNV) due to age related macula degeneration (AMD). The aim of this study was therefore to analyse functional results after PDT at a tertiary university centre.
Methods
We analysed retrospectively the files of 298 consecutive patients who had been treated for an active CNV due to AMD with PDT between 1999 and 2003. A total of 175 patients had subfoveal predominantly classic CNV due to AMD with107 and 44 patients respectively completing the one and two year follow-up. The treatment was performed according to the TAP protocol and regular follow-up examinations were performed using standarized ETDRS visual acuity measurements and fluorescein angiography. Visual acuity was then analysed after 12 and 24 months.
Results
The mean change of visual acuity for subfoveal predominantly classic CNV was -1.8 lines after one year and - 2.7 lines after two years. The percentage of patients where a moderate visual acuity loss of three or more lines could be prevented was 63.6% after one year and 50% after two years. 15.9% percent of the patients had an improvement of more than one line after one year and after two years. Severe visual acuity loss of more than six lines was observed in 14.0 % after one year and 25.0% after two years. A mean of 2.5 treatments were performed in the first year and 0.4 in the second year. After dichotomising into subfoveal localisation on the one hand and juxta- respectively extrafoveal localization of the CNV on the other hand, a significantly better mean change of visual acuity after one year (-1.8 lines vs. +0.9lines ; p = 0.002) and after two years (-2.7 vs. +0.9; p = 0.038) was observed.
Conclusions
The results presented here are comparable to the results of the TAP study. Almost identical results with regards to prevention of a moderate visual acuity loss in clinical routine could be obtained with a lower number of treatments. Juxta- and extrafoveal CNV showed a significantly better mean change of visual acuity.
