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M.R. Regenbogen, M. Goldstein, G. Heilweil, G. Treister, A. Loewenstein; The Value of the First PDT Results in Prediction of Visual Outcome . Invest. Ophthalmol. Vis. Sci. 2006;47(13):2116.
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With the rise of many different treatment options for neovascular age related macular degeneration (AMD) including combined Photodynamic Therapy (PDT) and triamcinolone, and various anti–angiogenic drugs, we wanted to evaluate the prognostic value of the first PDT result and to asses the role of further PDT treatments if the first PDT fails to show stabilization or improvement.
80 charts of patients who underwent their first PDT from 3/2002 – 10/2004 due to all types of subfoveal Choroidal Neovascularization (CNV) secondary to AMD were reviewed. Patients who suffered from any other ocular disease, as well as patients treated with prior laser, or who had combined therapy of PDT and triamcinolone were excluded. Visual acuity (VA), lesion size and lesion type, at baseline, 3 months and 12 months, were recorded. Statistical analysis was performed using Pearson Correlation Coefficients to find any correlation between success of the first treatment and stabilization in VA and reduced lesion size at 12 months. First treatment success was determined as improvement or stabilization in VA or in lesion size.
46 patients were included in the analysis. There were 18 females and 27 males. No statistically significant correlation was found between first PDT success (when defined as change in lesion size) and stabilization or improvement in VA after 12 months (P=0.0562), or between stabilization or improvement of VA after the first PDT and reduction in lesion size after 12 months (p=0.1377). Variant analysis between subgroups of CNV was unable to detect any statistical significant correlation.
No correlation was found between the results of the first PDT and the outcome determined by visual acuity or lesion size at 12 months. Therefore the decision upon continuing PDT should not be influenced by the results of the first PDT, and treatment indications should not differ from the ones suggested by the prior multi–center studies.
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