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Photodynamic therapy with verteporfin for choroidal neovascularisations in clinical routine outside the TAP study. One- and two-year results including juxtafoveal and extrafoveal CNV

  • Clinical Investigation
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Abstract

Introduction

The aim of this study was to analyse 1- and 2-year outcomes after photodynamic therapy (PDT) in clinical routine outside of the TAP [treatment of age-related macular degeneration (AMD) with PDT] study. We analysed the functional results, possible influencing factors and the rate of side effects.

Methods

We analysed the medical records of 210 consecutive patients between 50 and 93 years of age (73±9 years) who had been treated with PDT for active ≥50% classic CNV resulting from AMD. Only patients with a minimum follow-up of 1 year (127) were included; 52 patients completed 2 years of follow-up. Juxta- and extrafoveal CNV were also analysed. Treatment was given in accordance with TAP parameters and regular follow-up examinations were performed with standardised ETDRS visual acuity (VA) measurements and fluorescein angiography.

Results

In the subfoveal group, in 63.6% (70/110) a loss of VA ≥3 lines could be prevented after 1 year, and in 51.1% (23/45) after 2 years. An improvement of ≥1 line was found in 31.8% (1 year) and in 22.2% of eyes (2 years). Severe VA loss of ≥6 lines occurred in 10.9% of cases after 1 year and in 15.6% after 2 years. The mean change of VA was −1.7±3.4 lines (1 year) and −2.5±3.9 lines (2 years). For the group of CNV with juxta-/extrafoveal localisation, the mean change of VA was +0.8±2.5 lines after 1 year and +1.0±4.2 lines after 2 years. With regard to different CNV localisations, the results for juxta-/extrafoveal CNV are statistical significantly better (p=0.005 and p=0.035 after 1 and 2 years, respectively). A mean of 2.6 treatments were performed in the first year and 0.5 in the second year.

Conclusions

The results obtained in a single institution compare favourably with the results of the TAP study. The results regarding functional visual outcome could be obtained with a lower number of treatments in clinical practice. Juxta- and extrafoveal CNV showed significantly better results than a subfoveal localisation of the CNV. In this subgroup a mean improvement of VA could be obtained after 1 or 2 years.

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References

  1. Axer-Siegel R, Ehrlich R, Yassur Y, Rosenblatt I, Kramer M, Priel E, Benjamini Y, Weinberger D (2004) Photodynamic therapy for age-related macular degeneration in a clinical setting: visual results and angiographic patterns. Am J Ophthalmol 137(2):258–264

    Google Scholar 

  2. Barbazetto I, Burdan A, Bressler NM, Bressler SB, Haynes L, Kapetanios AD, Lukas J, Olsen K, Potter M, Reaves A, Rosenfeld P, Schachat AP, Strong HA, Wenkenstern A (2003) Photodynamic therapy of subfoveal choroidal neovascularization with verteporfin: fluorescein angiographic guidelines for evaluation and treatment—TAP and VIP report no. 2. Arch Ophthalmol 121(9):1253–1268

    Google Scholar 

  3. Barnes RM, Gee L, Taylor S, Briggs MC, Harding SP (2004) Outcomes in verteporfin photodynamic therapy for choroidal neovascularisation—‘beyond the TAP study’. Eye 18(8):809–813

    Article  CAS  PubMed  Google Scholar 

  4. Bird AC, Bressler NM, Bressler SB, Chisholm IH, Coscas G, Davis MD, de Jong PT, Klaver CC, Klein BE, Klein R, et al (1995) An international classification and grading system for age-related maculopathy and age-related macular degeneration. The International ARM Epidemiological Study Group. Surv Ophthalmol 39(5):367–374

    CAS  PubMed  Google Scholar 

  5. Bressler NM (2001) Photodynamic therapy of subfoveal choroidal neovascularization in age-related macular degeneration with verteporfin: two-year results of 2 randomized clinical trials—TAP report 2. Arch Ophthalmol 119(2):198–207

    PubMed  Google Scholar 

  6. Cohen SY, Bulik A, Dubois L, Quentel G (2003) Photodynamic therapy for juxtafoveal choroidal neovascularization in myopic eyes. Am J Ophthalmol 136(2):371–374

    Article  PubMed  Google Scholar 

  7. Gelisken F, Inhoffen W, Hermann A, Grisanti S, Bartz-Schmidt KU (2004) Verteporfin photodynamic therapy for extrafoveal choroidal neovascularisation in pathologic myopia. Graefes Arch Clin Exp Ophthalmol

  8. Macular Photocoagulation Study Group (1982) Argon laser photocoagulation for senile macular degeneration. Results of a randomized clinical trial. Arch Ophthalmol 100(6):912–918

    Google Scholar 

  9. Macular Photocoagulation Study Group (1986) Argon laser photocoagulation for neovascular maculopathy. Three-year results from randomized clinical trials. Macular Photocoagulation Study Group. Arch Ophthalmol 104(5):694–701

    Google Scholar 

  10. Macular Photocoagulation Study Group (1990) Krypton laser photocoagulation for neovascular lesions of age-related macular degeneration. Results of a randomized clinical trial. Macular Photocoagulation Study Group. Arch Ophthalmol 108(6):816–824

    Google Scholar 

  11. Macular Photocoagulation Study Group (1991) Subfoveal neovascular lesions in age-related macular degeneration. Guidelines for evaluation and treatment in the macular photocoagulation study. Macular Photocoagulation Study Group. Arch Ophthalmol 109(9):1242–1257

    Google Scholar 

  12. Macular Photocoagulation Study Group (1994) Laser photocoagulation for juxtafoveal choroidal neovascularization. Five-year results from randomized clinical trials. Macular Photocoagulation Study Group. Arch Ophthalmol 112(4):500–509

    Google Scholar 

  13. Schmidt-Erfurth U, Miller J, Sickenberg M, Bunse A, Laqua H, Gragoudas E, Zografos L, Birngruber R, van den Bergh H, Strong A, Manjuris U, Fsadni M, Lane AM, Piguet B, Bressler NM (1998) Photodynamic therapy of subfoveal choroidal neovascularization: clinical and angiographic examples. Graefes Arch Clin Exp Ophthalmol 236(5):365–374

    Google Scholar 

  14. TAP Study Group (1999) Photodynamic therapy of subfoveal choroidal neovascularization in age-related macular degeneration with verteporfin: one-year results of 2 randomized clinical trials—TAP report. Treatment of age-related macular degeneration with photodynamic therapy (TAP) Study Group. Arch Ophthalmol 117(10):1329–1345

    Google Scholar 

  15. Verteporfin Roundtable 2000 and 2001 Participants (2002) Guidelines for using verteporfin (visudyne) in photodynamic therapy to treat choroidal neovascularization due to age-related macular degeneration and other causes. Retina 22(1):6–18

    Google Scholar 

  16. VIP Study Group (2003) Verteporfin therapy of subfoveal choroidal neovascularization in pathologic myopia: 2-year results of a randomized clinical trial—VIP report no. 3. Ophthalmology 110(4):667–673

    Google Scholar 

  17. Wachtlin J, Heimann H, Behme T, Foerster MH (2003) Long-term results after photodynamic therapy with verteporfin for choroidal neovascularizations secondary to inflammatory chorioretinal diseases. Graefe Arch Clin Exp Ophthalmol 241:899–906

    Google Scholar 

  18. Wachtlin J, Wehner A, Heimann H, Foerster MH (2004) Photodynamic treatment with verteporfin for patients with idiopathic choroidal neovascularization: two-year results. Ophthalmologe 101(5):489–495

    Google Scholar 

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Correspondence to Joachim Wachtlin.

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Wachtlin, J., Stroux, A., Wehner, A. et al. Photodynamic therapy with verteporfin for choroidal neovascularisations in clinical routine outside the TAP study. One- and two-year results including juxtafoveal and extrafoveal CNV. Graefe's Arch Clin Exp Ophthalmol 243, 438–445 (2005). https://doi.org/10.1007/s00417-004-1071-z

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  • DOI: https://doi.org/10.1007/s00417-004-1071-z

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