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B. Gupta, S. Paul, S. Bhansali, V. Sharma, S. Natha; Does Smoking Affects the Final Outcome of Photodynamic Therapy for Wet AMD?. Invest. Ophthalmol. Vis. Sci. 2007;48(13):4570.
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To determine the difference in response and visual outcome at 12 months in smokers, non-smokers and ex-smokers who received photodynamic therapy (PDT) for classic and predominantly classic lesions of age related macular degeneration (AMD) as defined by TAP and VIP study
From October 2004 to October 2005 prospective data was collected on AMD patients with classic and predominantly classic membranes who received PDT treatment with a minimum 12 months follow-up.The setting was in a specialist retina clinic under a single medical retina specialist in a district general hospital in the United Kingdom. Baseline demographic information included whether the patient was non-smoker, ex-smoker or current smoker, Log Mar visual acuity (VA) and Greatest Linear Dimension (GLD) at the initial PDT treatment was recorded. Visual acuity and GLD during subsequent visits at month 3, 6, 9, and 12 were noted. Change in VA and GLD were calculated. Loss of vision of less than 15 ETDRS letters was considered as stable. Statistical analysis was done using Stats direct software.
77 patients receiving treatment completed minimum 12 months follow-up. There were 14 smokers(S), 38 ex-smokers(XS) and 25 non-smokers(NS). There was no statistically significant difference in the age at onset of the wet ARMD in the three groups. Mean baseline GLD of the three groups were 2132 mu(S), 2116 mu(XS) and 2187 mu(NS) respectively. Mean base line VA was 44.57(S), 47.21(XS), and 45.28(NS) ETDRS Letters respectively.GLD and average drop of visual acuity of the three groups at 12 month follow-up were 1787 mu(S), 2062 mu(XS) and 2280 mu(NS) and 1.6(S), 11.2(XS) and 6.5(NS) ETDRS letters respectively. There was no statistically significant difference between the three groups.A drop in vision of more than 15 ETDRS letters was noted in 35 % of the smokers as compared to 28% of non-smokers and ex-smokers.
Though it is a small study, it does not show any statistically significant difference between smokers, ex-smokers and non-smokers in terms of response to PDT treatment and visual outcome twelve months after initial treatment. Larger multicentre studies with longer follow-up period are needed in future.
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