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D. Tsuchiya, T. Yamamoto, K. Saito, H. Yamashita; Result of Photodynamic Therapy and Outcome of Visual Function in Cases of Age–Related Macular Degeneration . Invest. Ophthalmol. Vis. Sci. 2006;47(13):373.
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Photodynamic Therapy (PDT) has been confirmed to be effective in the treatment of subfoveal choroidal neovascularization (CNV) caused by age–related macular degeneration (AMD). The long–term effects and outcomes of require to be clarified. We reviewed the cases with CNV and investigated the therapeutic effect of PDT, causes of relapse and visual function after PDT.
Eighty eyes of 76 cases of AMD complicated by CNV were included. The mean age was 74.5 years (range: 50 to 90 years) and the mean follow–up period was 9.3 months (3 to 12 months). The therapeutic effects of PDT were assessed by fluorescein angiography (FA), indocyanine green angiography (IA), optical coherence tomography (OCT), and visual acuity.
In 80 eyes, CNV classified predominantly classic type in 18 eyes (22.5%), minimally classic in 11eyes (13.7%), and occult with no classic in 51 eyes (63.8%) and polypoidal choroidal vasculopathy were detected in 26 eyes (33.5%). Visual acuity was improved by 2 lines or over in 8 eyes (10.0%), did not change in 65 eyes (82.2%), decreased by 2 lines decrease or below in 7 eyes (8.8%). The CNV leakage increased in 12 eyes (15.0%) in the original regions, the leakage decreased incompletely in 15 eyes (18.8%), and the CNV occluded completely in 53 eyes (66.2%).The causes of the CNV exacerbation were as follows: CNV was hidden by subretinal hemorrhage in 3 cases (25%). The occult CNV lesions could not be detected completely in one eye (8.3%), CNV was complicated with angioid streaks in one eye (8.3%), and causes were not identified in 7 eyes (58.4%).The retinal thickness decreased by 59 eyes (73.4%) after PDT. No systemic complications were observed.
The exacerbation of CNV lesion was detected in the original CNV area in 15.0%, and the causes were not identified in 58.4%. Results indicated that 15.0% of cases increased the CNV leakage although appropriated PDT radiation was performed. Subretinal hemorrhage might increase the CNV leakage.
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