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R Isber-Soyeur, M-B Rougier, T Darquies, H Manic, H Manic, E Fourmaux, N Chobaux, J-F Korobelnik; Photodynamic Therapy for Choroidal Neovascularization in Age Related Macular Degeneration and Pathologic Myopia: Lens Status Implication . Invest. Ophthalmol. Vis. Sci. 2002;43(13):605.
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Background: The two-year results of the TAP study (Treatment of Age-related Macular Degeneration with Photodynamic Therapy ) show some benefit in the outcome of subfoveal choroidal neovascularization (CNV), as 59% of the patients keep on their visual acuity. In the Verteporfin in Photodynamic Therapy (VIP) study about subfoveal CNV secondary to Pathologic Myopia (PM), only the one-year results have been published and demonstrate a stability of the visual acuity for 72% of the patients. To our knowledge, there is no study about photodynamic therapy comparing results in phakic and pseudophakic eyes. Purpose:We report our experience about the early visual outcomes and lesion size evolution of subfoveal CNV secondary to Age Related Macular Degeneration (AMD) and Pathologic Myopia (PM) treated with Verteporfin. We compare the results depending on lens status. Methods:129 patients were treated with Verteporfin (Visudyne®; Ciba Vision Corp): 86 patients presented AMD with classic CNV, 43 patients with CNV and PM ( patients with Both classic and occult CNV were excluded from the study). ETDRS visual acuity, and lesion size measured on fluorescein angiography were performed prior to the first treatment, and every 3 months, comparing results between phakic and pseudophakic eyes. Results: For AMD patients, visual acuity improved or remained stable in 69% of phakic eyes and in 55% of pseudophakic eyes at 3 months, despite the size of membrane decreased in 65% in both subgroups. For PM patients, visual acuity improved or remained stable in 82% of phakic eyes and in 78%of pseudophakic eyes while the lesion size decreased in 76% and only 22% respectively. Conclusion: Despite limited follow-up, our results seem to confirm that PDT decreases the loss of vision in patients with CNV due to AMD and PM. Surprisingly, our preliminary results show that PDT in pseudophakic eyes may be less effective than in phakic eyes, both in AMD and PM. Transmission of infra-red laser through implants could explain these results. These conclusions must be confirmed with larger follow up and prospective studies.
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