Purchase this article with an account.
M. yamamoto, T. Kohno, H. Iwami, N. Miki, M. Kaida, M. Hirabayashi, A. Hamaguchi, K. Shiraki; Correlation Between Change in Visual Acuity and Lesion Size After Photodynamic Therapy Combined Intravitreal Pharmacosurgery in Age-Related Macular Degeneration With Classic Choroidal Neovascularization. Invest. Ophthalmol. Vis. Sci. 2010;51(13):75.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
To investigate the correlation between change in visual acuity and lesion size after photodynamic therapy (PDT) combined intravitreal triamcinolone or bevacizumab for age-related macular degeneration (AMD) with classic choroidal neovascularization.
Subjects comprised 46 AMD patients (47 eyes) treated by PDT in the Department of Ophthalmology at Osaka City University between October 2004 and July 2008, for whom at least 1 year had elapsed since treatment. There were 32 male eyes and 14 female eyes. Mean patient age was 73.5 years (range, 54-86 years). PDT alone was performed in 16 eyes (PDT alone group), 21 eyes were treated with combined intravitreal triamcinolone (IVTA-PDT group), and 10 eyes with combined intravitreal bevacizumab (IVB-PDT group).Changes in visual acuity before and 1 year after PDT were investigated, with decimal visual acuity converted to logMAR visual acuity. We compared the greatest linear dimensions of classic lesions only (C-GLD) on fluorescein angiography between before and 3 months after PDT. In addition, we examined the correlation of the change in C-GLD with visual acuity.
Change in mean logMAR visual acuity before and after 12 months PDT was 0.77 to 0.76, 0.86 to 67, and 0.63 to 0.33 in the PDT alone, IVTA-PDT, and IVB-PDT groups, respectively; visual acuity was significantly improved in the IVTA-PDT and IVB-PDT groups (PDT alone group: P=0.80; IVTA group: P<0.01; and IVB group: P<0.01, Wilcoxon signed-ranks test). Pretreatment mean C-GLD was 2501.6 µm, 2544.1 µm, and 2134.2 µm in the PDT alone, IVTA, and IVB groups, respectively, and the percentage reduction in C-GLD after 3 months was -9.1%, -32.4%, and -23.3%, respectively; C-GLD were significantly reduced in size in the IVTA-PDT and IVB-PDT groups (PDT alone group: P=0.06; IVTA-PDT group: P<0.001; IVB-PDT group: P<0.01, paired t-test). A correlation was observed in the change in visual acuity after 1 year with the percent reduction in C-GLD after 3 months (r=0.46, P<0.01, single regression analysis).
Combined IVTA or IVB is more effective than PDT alone on classic lesions and change in C-GLD after 3 months PDT was useful for visual prognosis.
This PDF is available to Subscribers Only