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M.J. Potter, S.J. Merchant, S.M. Szabo; Twelve Month Clinical Outcomes Following Treatment of Subfoveal Choroidal Neovascularization in Pathologic Myopia using Photodynamic Therapy with Verteporfin (Visudyne). . Invest. Ophthalmol. Vis. Sci. 2004;45(13):3144.
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Purpose: To determine if the beneficial effects of photodynamic therapy (PDT) with verteporfin (Visudyne; Novartis Ophthalmics, Duluth, GA) demonstrated in randomized clinical trials for patients with pathologic myopia (PM) can be achieved in a clinic setting. Methods: Prospective, non–comparative interventional study. One eye from all patients with bilateral myopia greater than –6 D with subfoveal choroidal neovascularization (CNV) secondary to PM, initially treated between July 2000 – December 2002, was included in analysis. PDT treatment, re–treatment and follow–up schedules were as outlined in the VIP (Verteporfin in PDT) Study, and ETDRS visual acuities recorded at every visit. Unlike the VIP Study, retreatment was at the discretion of the treating physician. The primary outcome measure was loss of <8 letters (1.5 lines) of ETDRS visual acuity, with the secondary outcome measures of maintenance (+4 letters) or improvement (>4 letter increase) in ETDRS acuity, over 12 months. Missing data was imputed using last observation carried forward. Results: Seventeen patients were included in the analysis. Ten patients were female (59%), 7 were male (41%), and the mean age was 61 years (range, 36 to 80). The mean myopic correction was –11.6 D (range, –7.8 to –16.8). Mean baseline ETDRS acuity was 52.5 letters (approximate Snellen equivalent, 20/100+2). All CNV lesions were predominantly classic on angiography at baseline. At 12 months, mean final ETDRS acuity was 49 letters (approximate Snellen equivalent, 20/100–1). Thirteen patients (76.5%) had lost <8 letters (1.5 lines) of ETDRS acuity, 13 patients (76.5%) had maintained or improved acuity, and 4 patients (23.5%) improved by >5 letters. Only 1 patient (5.9%) experienced severe (>30 letter) loss of visual acuity. Mean loss was 3 letters (0.6 lines). Mean number of treatments over 12 months was 2.9 (out of a possible 5). At 50 patient visits (58.9%) treatment was performed, at 29 patient visits (34.1%) no treatment was required, and 6 visits (7%) were missed.Conclusions: Clinically favorable outcomes were observed in this series. It appears that results in clinical practice are comparable to those acheived in the VIP Study for pathologic myopia.
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