Purchase this article with an account.
N.G. Ghazi, J.S. Tiedeman, B.P. Conway; Is Reduction in the Risk of Vision Loss the Only Benefit of Photodynamic Therapy in Predominantly Classic Subfoveal Choroidal Neovascularization? . Invest. Ophthalmol. Vis. Sci. 2003;44(13):1805.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
Purpose: To emphasize the beneficial effect of photodynamic therapy (PDT) on the size of the choroidal neovascular (CNV) lesion and evolution of the disciform scar (DS) in patients with predominantly classic subfoveal choroidal neovascularization (PCSFCNV), a probably underestimated benefit of PDT. Methods: Retrospective chart review of all patients who received PDT for subfoveal CNV (SFCNV) at the University of Virginia Health System during the years of 2000 and 2001. Only eyes that met the inclusion criteria of the study were included. In each study eye, the greatest linear dimension (GLD) of the treated lesion was recorded before and at the last follow up after PDT. Analysis of the GLD before and after treatment and measurement of the size of the potential DS post PDT were performed. Furthermore, a subgroup of patients who already had a DS in their fellow eye at presentation was studied. The size of the scar in this subgroup of eyes was compared to that of the potential scar in the study eyes of these patients and the rest of the patients. Results: During the specified period, 148 patients received PDT for SFCNV. Sixty-two eyes of 60 patients met the inclusion criteria of the study. Of these eyes, 95% had PCSFCNV due to age-related macular degeneration and 5% had similar lesions related to pathologic myopia and presumed ocular histoplasmosis syndrome. After an average follow up of 9-month, the size of the CNV lesion was stabilized or reduced in 64% of the study eyes while 36% had progression of the lesion. Forty five percent of the treated eyes had no evidence of CNV at last follow up. Only 3 study eyes (5%) developed DS following treatment. Fourteen patients (23%) had already had DS in their fellow eye at the time of the study and none of these eyes had previously received PDT. The size of the scar in these eyes was significantly larger than that of the potential scar in the study eyes of the same 14 patients and of the remaining patients. Conclusions: This study documents the beneficial effect of PDT on the size of the CNV lesion and on the evolution of the DS in PCSFCNV. This benefit has been probably overshadowed because of the emphasis that ophthalmologists invest in the direction of final visual acuity outcome. A smaller size of the CNV lesion and subsequent scar might be of great significance to patients, particularly those in whom PDT fails to prevent severe vision loss.
This PDF is available to Subscribers Only