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JD Givan, N Jabbour, JV Odom, M Leys; Systemic Factors Influencing Photodynamic Therapy for Age-Related Macular Degeneration . Invest. Ophthalmol. Vis. Sci. 2002;43(13):576.
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Purpose: We report the effects of common systemic medical conditions and medication usage upon treatment outcomes of photodynamic therapy (PDT) with VisudyneTM for age-related macular degeneration (ARMD). Methods: Patient chart review determined the presence or absence of several systemic medical disorders (i.e. hypertension, diabetes mellitus, and hypercholesterolemia), as well as, concomitant usage of various common systemic medications (i.e. ACE inhibitors, calcium channel blockers, ß-blockers, "statins," and non-steroidal anti-inflammatory drugs) for 76 eyes. All 76 eyes had recently undergone PDT for ARMD with a mean follow-up period of 6.2 months post-initial PDT treatment. Patients from both a university-based and private practice setting were included. Visual acuity (VA) examinations were then reviewed for each eye to determine if VA had improved/maintained baseline or worsened since the initiation of photodynamic therapy with respect to the systemic factors under investigation. Results: Overall, 37 of 76 (48.7%) eyes maintained baseline/increased VA (range: 0-3 lines) and 39 of 76 (51.3%) eyes experienced decreased VA (range: 1-4 lines) with regard to VA at the time of initial PDT treatment. However, patients undergoing concomitant «statin» therapy for hypercholesterolemia [19 of 76 eyes (25%)] and those on chronic ß-blocker therapy [10 of 76 eyes (13.2%)] maintained baseline/increased VA in 68.4% (13 of 19 eyes) and 70% (7 of 10 eyes) of cases, respectively. Of significant note, chronic non-steroidal anti-inflammatory drug (NSAID) usage, chronic hypertension, and diabetes did not appear to affect VA outcomes. Conclusion: We believe that concurrent «statin» and/or ß-blocker therapy may improve clinical outcomes in this patient population.
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