April 2010
Volume 51, Issue 13
Free
ARVO Annual Meeting Abstract  |   April 2010
Correlation Between Change in Visual Acuity and Lesion Size After Photodynamic Therapy Combined Intravitreal Pharmacosurgery in Age-Related Macular Degeneration With Classic Choroidal Neovascularization
Author Affiliations & Notes
  • M. yamamoto
    Ophthalmology & Visual Science, Osaka City Univ Medical School, Osaka-Shi, Japan
  • T. Kohno
    Ophthalmology & Visual Science, Osaka City Univ Medical School, Osaka-Shi, Japan
  • H. Iwami
    Ophthalmology & Visual Science, Osaka City Univ Medical School, Osaka-Shi, Japan
  • N. Miki
    Ophthalmology & Visual Science, Osaka City Univ Medical School, Osaka-Shi, Japan
  • M. Kaida
    Ophthalmology & Visual Science, Osaka City Univ Medical School, Osaka-Shi, Japan
  • M. Hirabayashi
    Shiraniwa Hospital, Ikoma-Shi, Japan
  • A. Hamaguchi
    Osaka Ekisaikai Hospital, Osaka-Shi, Japan
  • K. Shiraki
    Ophthalmology & Visual Science, Osaka City Univ Medical School, Osaka-Shi, Japan
Investigative Ophthalmology & Visual Science April 2010, Vol.51, 75. doi:
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      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.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose: : 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.

Methods: : 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.

Results: : 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).

Conclusions: : 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.

Keywords: age-related macular degeneration • photodynamic therapy • vascular endothelial growth factor 
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