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Y. Mitamura, M. Kubota-Taniai, K. Okada, M. Hayashi, T. Baba, S. Yamamoto; Severe Visual Acuity Decrease Immediate After Photodynamic Therapy for Age-Related Macular Degeneration. Invest. Ophthalmol. Vis. Sci. 2007;48(13):1806.
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To investigate clinical findings of patients whose visual acuity decreased severely immediately after photodynamic therapy (PDT) for age-related macular degeneration (AMD).
PDT was performed on 191 eyes of 189 patients between July 2004 and May 2006 at Chiba University Hospital. Of the 191 eyes, 19 eyes (9.7%) with a decrease of >0.2 in the logMAR visual acuity (VA) within one week after PDT were studied.
In these 19 eyes, type of choroidal neovascularization (CNV) was predominantly classic in 6 eyes, occult with no classic in 3 eyes, polypoidal choroidal vacsulopathy in 9 eyes, and retinal angiomatous proliferation in 1 eye. Mean of greatest linear dimension (GLD) of the CNV was 4248 µm in these 19 eyes, and 3577 µm in 172 eyes without severe visual acuity decrease. Mean logMAR VA in the 19 eyes was 0.65 before PDT, 1.11 at 1 week after PDT, 0.90 at 1 month, 0.82 at 2 months, and 0.59 at 3 months. The VA did not recover to the pretreatment levels in 7 of the 19 eyes. In the other 12 eyes, mean period in which VA recovered to the pretreatment level was 6.8 weeks. The decreased VA was due to an increase of subretinal fluid in 9 eyes (47.4%), increase of hemorrhage in 6 eyes (31.6%), and persistent impairment of choroidal circulation in 10 eyes (52.6%).
These results indicate that a severe decrease of the visual acuity occurs in approximately 10% of patients undergoing PDT, and that the VA does not recover to the pretreatment levels in some of these cases.
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