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W-H Lee, JT Thompson, RN Sjaarda; Visual Acuity Outcomes of Vitrectomy, Focal Laser Photocoagulation, and Photodynamic Therapy in the Treatment of Subfoveal Choroidal Neovascularization Arising from Age-Related Macular Degeneration . Invest. Ophthalmol. Vis. Sci. 2002;43(13):3983.
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Purpose: To compare the visual outcomes of vitrectomy, thermal laser photocoagulation, and photodynamic therapy in the treatment of subfoveal choroidal neovascularization (SFCNV) arising from age-related macular degeneration (AMD). Methods: Retrospective case-control study of 23 consecutive eyes that underwent vitrectomy (VTX) versus 23 non-consecutive eyes that received laser photocoagulation (laser) versus 23 non-consecutive eyes that had photodynamic therapy (PDT) for SFCNV in AMD. Cases and case-controls were matched for pre-treatment visual acuity and for size of subfoveal choroidal neovascular membrane and were followed for a mean duration of 64.3 weeks. Results: The mean pre-treatment visual acuities were 20/250 for the vitrectomy eyes, 20/250+2 for the laser eyes, and 20/320+2 for the pDT eyes (p=0.897). At 3 months, the mean visual acuities decreased to 20/400-1, 20/400, and 20/400+2 for the VTX, laser, and PDT groups, respectively (p=0.802). The vitrectomy group lost 2 lines, and the laser group lost 1.7 lines, whereas the PDT group lost 1 line (p=0.770). At a mean of 64.3 weeks post-treatment, the mean visual acuities for the VTX, laser, and PDT groups were 20/640, 20/500, and 20/400 (p=0.506). The vitrectomy group lost 3.7 lines, the laser group lost 2.5 lines, and the PDT group lost 1.5 lines (p=0.392). Conclusion: Photodynamic therapy appears to be more effective in slowing the deterioration of vision in the treatment of subfoveal choroidal neovascularization arising from age-related macular degeneration compared to vitrectomy or thermal laser photocoagulation.
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