PURPOSE: The aim of this study was to evaluate the results of photodynamic therapy (PDT), using verteporfin, for subfoveal neovascular age-related macular degeneration (ARMD) with retinal angiomatous proliferation (RAP) with pigment epithelial detachment (PED) and/or choroidal neovascularization (CNV). METHODS: In this non-comparative, consecutive, interventional, case series, the data on 21 eyes (19 with stage 2 and two with stage 3 RAP) of 20 patients were reviewed. Serous PED occupied more than 50% of the lesion in 19 eyes. PDT was performed as per TAP protocol. Biomicroscopy and fluorescein and indocyanine-green angiography were performed to evaluate anatomical results and need for retreatment. Changes from baseline in best-corrected visual acuity (BCVA), and complications, were assessed. RESULTS: A mean of 3.5+/-0.9 treatments was performed. After 13.7+/-2.2 months, mean BCVA decreased from 20/80 to 20/174 (P=0.0063). In six eyes (28.6%) BCVA remained stable, whereas in 15 eyes (71.5%) it decreased. Occlusion of RAP and flattening of PED was observed in three (14.2%) eyes, conversion to disciform lesion in one (4.7%), and persistence of PED in 11 eyes (52.3%). One eye (4.7%) evolved to haemorrhagic PED, and one (4.7%) toward stage 3 RAP. A tear in the retinal pigment epithelium (RPE) was observed in four eyes (19%). Eleven (52.3%) showed progression of leakage, six moderate leakage (28.6%), and three (14.2%) absence of leakage. CONCLUSIONS: Timely PDT with verteporfin in the early stages in eyes with smaller lesions has the potential for a beneficial effect on vision, whereas it might worsen the natural course of larger lesions, with most eyes undergoing enlargement, disciform transformation or RPE tear.
PURPOSE: The aim of this study was to evaluate the results of photodynamic therapy (PDT), using verteporfin, for subfoveal neovascular age-related macular degeneration (ARMD) with retinal angiomatous proliferation (RAP) with pigment epithelial detachment (PED) and/or choroidal neovascularization (CNV). METHODS: In this non-comparative, consecutive, interventional, case series, the data on 21 eyes (19 with stage 2 and two with stage 3 RAP) of 20 patients were reviewed. Serous PED occupied more than 50% of the lesion in 19 eyes. PDT was performed as per TAP protocol. Biomicroscopy and fluorescein and indocyanine-green angiography were performed to evaluate anatomical results and need for retreatment. Changes from baseline in best-corrected visual acuity (BCVA), and complications, were assessed. RESULTS: A mean of 3.5+/-0.9 treatments was performed. After 13.7+/-2.2 months, mean BCVA decreased from 20/80 to 20/174 (P=0.0063). In six eyes (28.6%) BCVA remained stable, whereas in 15 eyes (71.5%) it decreased. Occlusion of RAP and flattening of PED was observed in three (14.2%) eyes, conversion to disciform lesion in one (4.7%), and persistence of PED in 11 eyes (52.3%). One eye (4.7%) evolved to haemorrhagic PED, and one (4.7%) toward stage 3 RAP. A tear in the retinal pigment epithelium (RPE) was observed in four eyes (19%). Eleven (52.3%) showed progression of leakage, six moderate leakage (28.6%), and three (14.2%) absence of leakage. CONCLUSIONS: Timely PDT with verteporfin in the early stages in eyes with smaller lesions has the potential for a beneficial effect on vision, whereas it might worsen the natural course of larger lesions, with most eyes undergoing enlargement, disciform transformation or RPE tear.
Authors: Kevin J Blinder; Mark S Blumenkranz; Neil M Bressler; Susan B Bressler; Guy Donato; Hilel Lewis; Jennifer I Lim; Ugo Menchini; Joan W Miller; Jordi M Mones; Michael J Potter; Constantin Pournaras; Al Reaves; Philip Rosenfeld; Andrew P Schachat; Ursula Schmidt-Erfurth; Michel Sickenberg; Lawrence J Singerman; Jason S Slakter; H Andrew Strong; Gianni Virgili; George A Williams Journal: Ophthalmology Date: 2003-04 Impact factor: 12.079
Authors: D Husain; M Kramer; A G Kenny; N Michaud; T J Flotte; E S Gragoudas; J W Miller Journal: Invest Ophthalmol Vis Sci Date: 1999-09 Impact factor: 4.799
Authors: J S Slakter; L A Yannuzzi; U Schneider; J A Sorenson; A Ciardella; D R Guyer; R F Spaide; K B Freund; D A Orlock Journal: Ophthalmology Date: 2000-04 Impact factor: 12.079
Authors: Luiz Henrique Schurig Fernandes; K Bailey Freund; Lawrence A Yannuzzi; Richard F Spaide; Sheau J Huang; Jason S Slakter; John A Sorenson Journal: Retina Date: 2002-10 Impact factor: 4.256
Authors: Alexandros A Rouvas; Thanos D Papakostas; Ioannis D Ladas; Ioannis Vergados Journal: Graefes Arch Clin Exp Ophthalmol Date: 2007-10-24 Impact factor: 3.117