Purchase this article with an account.
B. Wiechens, F. Mohammadi Rad, H. Hecker, U. Weber; Results After PDT vs. TTT of Occult CNV in Age–Related Macular Degeneration in Correlation to Lesion Size . Invest. Ophthalmol. Vis. Sci. 2005;46(13):339.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
Purpose: Since October 2001 over 450 photodynamic therapies (PDT) were performed in the Dept. of Ophthalmology at the Klinikum Hannover and over 100 transpupillary thermotherapies (TTT) in the Dept. of Ophthalmology at the Klinikum Braunschweig. This study was performed to investigate the results after PDT– and TTT–treatment of occult choroidal neovascularization (CNV) in exudative age–related macular degeneration (AMD) in correlation to the size of the lesion. Methods: For this study 41 eyes of 38 patients with occult CNV in AMD were included who were treated by PDT and 74 eyes of 73 patients who were treated by TTT between 11/01 and 09/03. PDT treatment parameters/criteria were according to the VIP study, TTT treatment modalities according to known parameters. The mean age of the patients at the time of first treatment was 75.8 years (58–88 years) and 77.3 years (55–94 years) respectively. Complete eye examination, fluorescein angiogram (F–AG) and ICG–AG was performed at baseline and follow–up visits every 3 months. Re–treatment was performed only in those cases with angiographic findings and clinical deterioration. Size of leakage area was calculated by digital measurement in the late phase of FAG and divided into 3 groups in correlation to disc areas (DA): PDT/TTT: <1 DA: 3/44; 1.5 – 2.5 DA: 35/24 and > 3.0 DA: 3/6. Baseline mean visual acuity (V.A.) was 0.31 + 0.17 in the PDT–group, and 0.18 + 0.14 in the TTT–group. Mean follow–up was 14.9 months (6–37 months). Statistical analysis was performed by Fisher's Exact Test, Mann–Whitney–U–Test, Χ2–Test and Cochran–Armitage–Trend–Test. Results: 53.6 % of eyes after PDT and 72.9 % eyes after TTT had a stable or increased V.A. at the end of follow–up (p=0,1051, p=0,1360). V.A. decreased in 46.3 and 27.0 % of eyes (p=0.0469). In 76.0 – 80.7 % fluorescein leakage was reduced. Stabilization or reduction of metamorphopsia was observed in 75 – 85 %. The leakage size did not correlate with the final result and PDT/TTT: : <1: p=0.101, 1.5 – 2.5: p=0.604 and > 3.0: p=0.762. The mean number of PDT–treatments per case was 1.9 (range: 1–4), the number of TTT–treatments per case was 2.2 (range: 1–4). Conclusions: PDT and TTT showed comparable results in this retrospective study. Results did not correlate to the size of the leakage. Re–treatment may not be mandatory if visual acuity and metamorphopsia are stable. A prospective controlled study is needed to further investigate these treatment modalities of occult CNV in exudative AMD.
This PDF is available to Subscribers Only