Visual outcome of photodynamic therapy for typical neovascular age-related macular degeneration and polypoidal choroidal vasculopathy over 5 years of follow-up
- 307 Downloads
To evaluate the long-term effects of photodynamic therapy (PDT) on typical neovascular age-related macular degeneration (tAMD) and polypoidal choroidal vasculopathy (PCV).
This was a multicenter prospective study of 139 eyes from 136 patients (tAMD: 74 eyes; PCV: 65 eyes) who underwent PDT as the initial treatment. The change in best-corrected visual acuity (BCVA), predictive factors for the BCVA at 60 months, frequency of recurrence, and mean recurrence period were analyzed.
The pre-PDT BCVA and greatest linear dimension (GLD) did not differ between the two groups. The mean BCVA (logMAR) was significantly improved at 6 months post-initial PDT (post-PDT) in the PCV group (−0.11, P = 0.0091). However, at 60 months post-PDT, the mean BCVA was significantly worse than baseline in the tAMD (+0.21, P = 0.0035) and PCV (+0.21, P = 0.0076) groups. Pre-PDT BCVA, age, and GLD were the factors significantly associated with the BCVA at 60 months post-PDT. Although the frequency of recurrence did not significantly differ between the two phenotype groups, the mean recurrence period was significantly longer in the PCV group than in the tAMD group (15.7 vs. 8.6 months, P = 0.0020).
PDT may not have benefits for visual acuity in cases of tAMD and PCV over 5 years of follow-up.
KeywordsLong-term outcome Photodynamic therapy Age-related macular degeneration Polypoidal choroidal vasculopathy Multicenter study
- 13.Bressler NM, Chang TS, Fine JT, Dolan CM, Ward J, Anti-VEGF Antibody for the Treatment of Predominantly Classic Choroidal Neovascularization in Age-Related Macular Degeneration (ANCHOR) Research Group. Improved vision-related function after ranibizumab vs photodynamic therapy: a randomized clinical trial. Arch Ophthalmol. 2009;127:13–21.PubMedCrossRefGoogle Scholar
- 14.Matsumiya W, Honda S, Bessho H, Kusuhara S, Tsukahara Y, Negi A. Early responses to intravitreal ranibizumab in typical neovascular age-related macular degeneration and polypoidal choroidal vasculopathy. J Ophthalmol. 2011;742020. doi:10.1155/2011/742020.
- 21.Kurashige Y, Otani A, Sasahara M, Yodoi Y, Tamura H, Tsujikawa A, et al. Two-year results of photodynamic therapy for polypoidal choroidal vasculopathy. Am J Ophthalmol. 2008;146:513–9.Google Scholar
- 22.Honda S, Imai H, Yamashiro K, Kurimoto Y, Kanamori-Matsui N, Kagotani Y, et al. Comparative assessment of photodynamic therapy for typical age-related macular degeneration and polypoidal choroidal vasculopathy: a multicenter study in Hyogo prefecture, Japan. Ophthalmologica. 2009;223:333–8.PubMedCrossRefGoogle Scholar
- 23.Honda S, Kurimoto Y, Kagotani Y, Yamamoto H, Takagi H, Uenishi M, Hyogo Macular Disease Study Group. Photodynamic therapy for typical age-related macular degeneration and polypoidal choroidal vasculopathy: a 30-month multicenter study in Hyogo, Japan. Jpn J Ophthalmol. 2009;53:593–7.PubMedCrossRefGoogle Scholar
- 24.Kaiser PK, Treatment of Age-Related Macular Degeneration with Photodynamic Therapy (TAP) Study Group. Verteporfin therapy of subfoveal choroidal neovascularization in age-related macular degeneration: 5-year results of two randomized clinical trials with an open-label extension: TAP report no. 8. Graefes Arch Clin Exp Ophthalmol. 2006;244:1132–42.Google Scholar
- 25.Treatment of Age-Related Macular Degeneration with Photodynamic Therapy (TAP) Study Group. Photodynamic therapy of subfoveal choroidal neovascularization in age-related macular degeneration with verteporfin. One-year results of 2 randomized clinical trials: TAP report 1. Arch Ophthalmol. 1999;117:1329–45.Google Scholar
- 26.Verteporfin in Photodynamic Therapy Study Group. Verteporfin therapy of subfoveal choroidal neovascularization in age-related macular degeneration: two-year results of a randomized clinical trial including lesions with occult with no classic choroidal neovascularization: verteporfin in photodynamic therapy report 2. Am J Ophthalmol. 2001;131:541–60.CrossRefGoogle Scholar
- 29.Koh A, Lee WK, Chen LJ, Chen SJ, Hashad Y, Kim H, et al. EVEREST STUDY: efficacy and safety of verteporfin photodynamic therapy in combination with ranibizumab or alone versus ranibizumab monotherapy in patients with symptomatic macular polypoidal choroidal vasculopathy. Retina. 2012;32:1453–64.PubMedCrossRefGoogle Scholar
- 30.Heier JS, Boyer DS, Ciulla TA, Ferrone PJ, Jumper JM, Gentile RC, FOCUS Study Group, et al. Ranibizumab combined with verteporfin photodynamic therapy in neovascular age-related macular degeneration: year 1 results of the FOCUS Study [published correction appears in Arch Ophthalmol. 2007;125:138]. Arch Ophthalmol. 2006;124:1532–42.PubMedCrossRefGoogle Scholar
- 32.Hara R, Kawaji T, Inomata Y, Tahara J, Sagara N, Fukushima M, et al. Photodynamic therapy alone versus combined with intravitreal bevacizumab for neovascular age-related macular degeneration without polypoidal choroidal vasculopathy in Japanese patients. Graefes Arch Clin Exp Ophthalmol. 2010;248:931–6.PubMedCrossRefGoogle Scholar
- 33.Bressler NM, Treatment of Age-Related Macular Degeneration with Photodynami Therapy (TAP) Study Group. 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. 2001;119:198–207.Google Scholar