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E. Fletcher, J. Khan, G. Menon, V. Chong; Predictive Factors for Predominantly Classic Choroidal Neovascular Membrane Enlargement Following Photodynamic Therapy . Invest. Ophthalmol. Vis. Sci. 2006;47(13):2100.
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Enlargement of choroidal neovascularisation (CNV) after photodynamic therapy (PDT) is commonly associated with poor visual outcome. We would like to identify predictive features of CNV enlargement on the baseline angiogram.
Analysis of photographic and angiographic features in 160 patients with predominantly classic CNV in two retinal centres, King’s College Hospital, London and Frimley Park Hospital, Surrey. The following baseline characteristics were evaluated: i) amount of leakage of CNV lesion at baseline ii) baseline lesion size iii) grading into the presence or absence of occult CNV iv) presence of associated retinal haemorrhage v) presence of a choroidal halo.
90 eyes showed significant CNV enlargement following PDT. 70 eyes were classified as non–enlarging. The difference in mean baseline size in the enlarging group (1.18 mm2) compared with the non–enlarging group (3.20 mm2) was statistically significant (p=0.009). The amount of leakage at 1 minute and the presence of a halo showed a trend towards increased risk of enlargement. The presence of occult CNV did not affect enlargement
Smaller lesions at baseline are significantly associated with CNV enlargement following first PDT treatment. This data may be useful when considering the use of adjunctive therapy such as intravitreal triamcinolone or anti–VEGF therapies at baseline..
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