Abstract
Abstract: :
Purpose: To determine the incidence of recurrence of choroidal neovascular membranes (CNV) at 18 months after treatment with photodynamic therapy (PDT) with verteporfin in patients with age–related macular degeneration. Methods: This is a prospective study of consecutive patients treated with PDT, who received their last treatment between October 2001 and May 2003. Potential patients were limited to those that lived in our metropolitan area, who had cessation of leakage on fluorescein angiography at the end of their treatment course with PDT for CNV in AMD. Study visits consisted of an ETDRS visual acuity measurement and fundus photography 18 months after the last PDT treatment. All photographs and visual acuity measurements were reviewed and compared to 18 months previous data, in a masked fashion, to determine if there had been a recurrence. The same information was collected on patients that had presented for treatment of known recurrences during this same time interval. Incidence of CNV recurrence was then calculated. Results: Seventy–six eyes of 73 patients were identified as study candidates. Fifteen patients refused participation (20.5%); 5 patients were ill, 1 patient could not be contacted, and 9 thought the travel distance was too far. Forty–five of 73 patients (61.6%) have completed follow up to date (representing 48 eyes). Recurrences were observed in 14 of the 48 eyes followed to date (29.2%) over an 18–month period of follow up. Two of these were judged to not be clinically meaningful as the ETDRS visual acuity was very low (<20/400) prior to recurrence. Only one patient with a recurrence had re–presented at the clinic within the 18 month follow up window, and nine recurrences had gone undetected prior to the patient returning for study follow up. Four patients that experienced recurrences were still being followed for treatment of their fellow eye. Conclusions: CNV recurrences are relatively common in patients treated with PDT for CNV in AMD, within 1.5 years of follow up. Retinal specialists should consider the possibility of recurrence when planning patient follow up.
Keywords: photodynamic therapy • choroid: neovascularization • age-related macular degeneration