Abstract
Abstract: :
Purpose: To determine the efficacy of photodynamic therapy (PDT) for juxtafoveal or extrafoveal lesions with mainly classic components in age-Related macular degeneration (AMD) and other disorders, in which treating surgeon deferred thermal laser to avoid scotoma. Methods: Retrospective review of pretreatment fluorescein angiograms from April 2000 to December 2001 in a large multiphysician retina practice. Results: Forty-one eyes of 40 patients were reviewed. Age ranged from 35 to 94 (mean =72.2). Treated diseases included: AMD (27 eyes, 65.9%), myopic degeneration (5 eyes, 12.2%), multifocal choroiditis (MFC) (3 eyes of 2 patients, 7.3%), polypoidal choroidal vasculopathy (PCV) (2 eyes, 4.9%), retinal angiomatous proliferation (RAP) (2 eyes, 4.9%), presumed ocular histoplasmosis syndrome (POHS) (1 eye, 2.4%) and idiopathic choroidal neovascularization (ICNV) (1 eye, 2.4%). Pretreatment CNV was predominantly classic in 32 eyes (78%); location was juxtafoveal in 31 eyes (76%) and extrafoveal in 10 eyes (24%). Initial best-corrected Snellen acuity (VA) ranged from 20/25 to 20/1600 (mean =20/200) and final VA ranged from 20/20 to 20/1600 (mean =20/200). The number of treatments ranged from 1 to 6 (mean = 2.4). VA improved by 2 or more lines in 12 eyes (29%), stabilized in 14 (34 %), and decreased 2 or more lines in 15 (37 %). Final VA was 20/100 or better in 19 eyes, including 12 eyes with AMD (44% of original 27 eyes), 2 (40%) with myopic degeneration, 2 (67%) with MFC, 1 (50%) with PCV, 1 (50%) with RAP, 1 (100%) with POHS, and 1 (100%) with ICNV. Conclusion: Treatment of extrafoveal and juxtafoveal lesions with PDT is associated with partial stabilization and improvement of visual acuity in some cases. Approximately 40% of patients with AMD and myopic degeneration achieve a final vision ≷ 20/100. Further research is required to determine the prognosis and response to PDT of patients with extrafoveal and juxtafoveal choroidal neovascularization.
Keywords: 346 choroid: neovascularization • 516 photodynamic therapy • 460 macula/fovea