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DC Fletcher, RA Schuchard, JP Walker, GL Wing, PA Raskauskas, TA Ghuman; SLO Macular Scotoma Size Benefitted by PDT . Invest. Ophthalmol. Vis. Sci. 2002;43(13):3979.
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Purpose:To determine if the size of SLO (scanning laser ophthalmoscope) determined macular scotomas was affected by PDT (Photodynamic Therapy). Methods:Sixty-four patients with wet ARM had visual acuity and SLO macular perimetry performed prior to PDT and 3 months post treatment. 12 month post treatment data has been collected in 8 patients and all patients will be completed in 4 months. Dense scotomas were determined with a 50,000 troland stimulus. Results:Pre treatment best corrected visual acuity (VA) range was 20/25 - 20/1000, median 20/250. 3 month post treatment VA range was 20/20 - 20/1000, median 20/400, with statistical analysis showing 42% improved, 14% unchanged and 44% worse. Pre treatment area of central scotoma in degrees2 (scotoma) range was 0 - 240, mean 47. The 3 month post treatment scotoma range was 0 - 240, mean 39, with statistical analysis showing 42% improved, 35% unchanged and 23% worse. The 3 month mean scotoma size decreased by 18%. In patients with worse VA, 68% still had significant stabilization or improvement of their scotoma. Preliminary 12 month post PDT data shows visual acuity stable or improved in 13% of patients and scotoma to be stable or improved in 50% of patients. Conclusion:This study showed that at 3 months post PDT more patients had stabilization or improvement in scotoma than VA. The majority of patients that had a decrease in VA had a stabilization or improvement in scotoma. Preliminary 12 month data continues to show more scotoma than VA benefit. The size of central scotomas is very significant to low vision rehabilitation for reading and other activities of daily living, independent of acuity. This affect on central field may represent a significant benefit of PDT that is not demonstrated by the numerous studies that only use acuity as an outcome measure.
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