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MJ Potter, SM Szabo; Photodynamic Therapy with Verteporfin Rescue Following Limited Macular Translocation Surgery in Age-Related Macular Degeneration . Invest. Ophthalmol. Vis. Sci. 2002;43(13):579.
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Purpose: To describe the clinical findings in two patients with age-related macular degeneration (AMD) treated with photodynamic therapy (PDT) with verteporfin (Visudyne; Novartis Ophthalmics, Duluth, GA) for recurrent choroidal neovascularization (CNV) following limited macular translocation surgery. Methods: Two patients with unilateral CNV secondary to AMD underwent limited macular translocation surgery and subsequent laser photocoagulation. Fifteen (Patient 1) and twenty-four (Patient 2) months later, there was a recurrence of CNV in both individuals. Each patient received PDT with verteporfin at three month intervals, if leakage was detected on fluorescein angiography. Pre- and post-treatment visual acuities and fluorescein angiograms were recorded for both patients. Results: Patient 1 had an initial visual acuity of 9/200 OS, improving to 20/60 on the Snellen chart following limited macular translocation surgery. PDT was performed for recurrent CNV fifteen months later, at which time visual acuity was 20/50-1 on the ETDRS chart. Following 5 PDT treatments over 15 months, final ETDRS acuity was 20/126-2, and minimal leakage was seen on fluorescein angiography. Patient 2 had an initial visual acuity of 20/400 OD that improved to 20/200 on the Snellen chart following limited macular translocation surgery. PDT was performed 24 months later for recurrent CNV. Visual acuity prior to PDT was 20/126+2 on the ETDRS chart, improving to a final visual acuity of 20/100+2 following 3 PDT treatments over the course of 8 months. Minimal leakage was visible on fluorescein angiography following the final PDT treatment. Conclusion: PDT with verteporfin may be an effective rescue strategy for recurrent CNV following limited macular translocation surgery in AMD. Further studies will be required to determine the optimal treatment for such patients.
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