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M.J. Goff, W.C. Bauman; Early Re-treatment of Choroidal Neovascularization After Photodynamic Therapy . Invest. Ophthalmol. Vis. Sci. 2003;44(13):5027.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: To determine if early re-treatment of choroidal neovascularization (CNV) with photodynamic therapy (PDT) with verteporfin results in better visual outcomes than standard re-treatment protocols as used in the Treatment of Age-related Macular Degeneration with Photodynamic Therapy (TAP) study group. Methods: Records of 14 consecutive patients were reviewed from November 2000 to November 2002. Standardized visual acuity was measured using ETDRS charts. Each patient was treated for subfoveal CNV with photodynamic therapy with verteporfin. Patients were re-evaluated at one month after treatment. Re-treatment was performed for clinical deterioration and persistent or worsening angiographic leakage from CNV. The primary outcome was the proportion of eyes with fewer than 15 letters lost (approximately < 3 lines of loss). This data was compared to similar data from the TAP study group (TAP report 1) in which angiography and re-treatment were considered at three-month intervals. Results: Twelve of 14 patients (86%) who received early re-treatment lost fewer than 15 letters of visual acuity from baseline, with an average time of follow up of 10 months. In the TAP study, 46% of patients who received placebo, and 61% of patients who received treatment lost fewer than 15 letters of visual acuity from baseline. Using the Fisher's exact test, a p-value of 0.09 was obtained comparing the early re-treatment group to the TAP treatment group. Conclusions: This small, consecutive , pilot study suggests that early re-treatment of CNV with PDT may provide better visual acuity outcomes compared to current verteporfin treatment recommendations. Although this study did not reach statistical significance, the outcome suggests improved stabilization of vision with early re-treatment.
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