Full macular translocation (FMT) versus photodynamic therapy (PDT) with verteporfin in the treatment of neovascular age-related macular degeneration: 2-year results of a prospective, controlled, randomised pilot trial (FMT-PDT)

  • Matthias Lüke
  • Focke Ziemssen
  • Michael Völker
  • Elke Altpeter
  • Julia Beutel
  • Dorothea Besch
  • Karl Ulrich Bartz-Schmidt
  • Faik Gelisken
Retinal Disorders

DOI: 10.1007/s00417-009-1050-5

Cite this article as:
Lüke, M., Ziemssen, F., Völker, M. et al. Graefes Arch Clin Exp Ophthalmol (2009) 247: 745. doi:10.1007/s00417-009-1050-5

Abstract

Background

To report the outcome of best-corrected visual acuity (BCVA), near visual acuity (NVA), contrast sensitivity (CS) and vision-related quality of life (VRQOL) in patients 2 years after undergoing photodynamic therapy (PDT) or full macular translocation (FMT) for the treatment of neovascular age-related macular degeneration (AMD).

Methods

Fifty patients with predominantly classic subfoveal choroidal neovascularisation (CNV) secondary to AMD were randomized to PDT or FMT. BCVA was determined according a standardized protocol with ETDRS charts. NVA were calculated after testing with SNAB (Swiss National Association of and for the Blind) visual acuity cards. CS was measured with Pelli-Robson charts. The 39-item National Eye Institute Visual Function Questionnaire (NEI-VFQ-25 plus supplement) was performed. Primary end points were the changes of BCVA, NVA, CS and VRQOL at 24-month examination.

Results

A stabilisation of BCVA (+0.3 letters) was found in the FMT group, whereas a decrease of more than 12 letters (-12.6 letters) was found in the PDT group (p = 0.052). Mean NVA improved by 7.0 letters in the FMT group and was superior to the PDT group (−9.6 letters, p = 0.036), while mean CS showed a time-dependent decrease in both treatment groups (FMT: −3.3 letters, PDT: −3.8 letters, p = 0.726). Considering the results of the VRQOL scores, the improvement of the subscales scores for general vision (p = 0.015), mental health (p = 0.028) and near activity (p = 0.020) were significantly higher in the FMT group.

Conclusions

FMT can stabilise BCVA and improve NVA over a period of 2 years in patients with subfoveal classic CNV secondary to neovascular AMD, whereas a decrease of BCVA and NVA was found in the PDT group. CS did not differ between FMT and PDT. A significant increase of VRQOL scores was only found in the FMT group and not in the PDT group. FMT seems to be a therapeutic approach that can increase visual function resulting in an improvement of patient’s VRQOL, but exhibits a higher number of severe complications compared to PDT.

Keywords

Age-related macular degeneration Macular translocation Photodynamic therapy Best corrected visual acuity Near visual acuity Contrast sensitivity Vision-related quality of life 

Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  • Matthias Lüke
    • 1
    • 2
  • Focke Ziemssen
    • 2
  • Michael Völker
    • 2
  • Elke Altpeter
    • 2
  • Julia Beutel
    • 1
    • 2
  • Dorothea Besch
    • 2
  • Karl Ulrich Bartz-Schmidt
    • 2
  • Faik Gelisken
    • 2
  1. 1.University Eye HospitalUniversity of LübeckLübeckGermany
  2. 2.University Eye Hospital, Centre for OphthalmologyEberhard-Karls University of TuebingenTuebingenGermany

Personalised recommendations