Abstract
Abstract: :
Purpose: To investigate the number of treatments necessary to stabilize the SRNVM in exudative AMD and the impact of PDT/ intravitreal Kenalog (IVK) on treatment cost compared with PDT alone. Methods: In a retrospective review of patients with subfoveal SRNVM who received PDT/IVK and PDT alone, the number of treatments required to stabilize the visual acuity and fluorescein angiographic characteristics of SRNVM were determined. Cost analysis for both treatment arms and their reported complications are extrapolated to yield annual US expenditure for both treatment options. Results:Each group had 11 patients who were closely matched for age, gender, age and VA. The PDT group was composed of predominantly classical membranes (100%) whereas 64% of the membranes in the PDT/IVK group were occult. Fewer treatments were required in the PDT/IVK group to stabilize the VA (1.45 ± 0.52 vs. 3.27 ± 0.79, p<0.001). There was a tendency to yield a better final VA with PDT/IVK treatment (20/75±20/85 vs. 20/137±20/146, p=0.158). The cost benefit from PDT/IVK over PDT was estimated to be 160 million dollars a year in the US. Conclusions: Since our study was a retrospective review and the treatment groups had a different incidence of classic and occult CNV, we can not come to any definitive conclusions. However, our observations suggest that concurrent application of IVK may decrease the number of PDT applications and substantially reduce the cost of care in patients with subfoveal SRNVM associated with AMD.
Keywords: age-related macular degeneration • photodynamic therapy