Background: Choroidal neovascularisations (CNV) is themajor cause of significant visual loss in patients with angioid streaks. We evaluated the functional and morphological outcome of Verteporfin photodynamic therapy ...Background: Choroidal neovascularisations (CNV) is themajor cause of significant visual loss in patients with angioid streaks. We evaluated the functional and morphological outcome of Verteporfin photodynamic therapy (PDT) in the treatment of these patients. Methods: This was a retrospective study in two tertiary referral centres over a 3-year period. Examinations included visual acuity assessment with ETDRS charts, binocular fundoscopy and fluorescein angiography. PDT was performed with standard parameters; earlier retreatments were feasible in activeCNV. Results: Fifteen eyes from 12 patients (9 male, 3 female) with a follow-up of 12-50 months (mean 26.1, median 19 months) were included. Five lesions were extraor juxtafoveal and ten were subfoveal. Baseline visual acuity was between 20/63 and 20/16 (mean 20/32, median 20/32). Eyes were treated with two to eight treatments of PDT (mean 4.2, median 4). Treatment intervals were between 5.6 and 72 weeks (mean 12.1, median 9.2 weeks). At the 1-year followup, visual acuity was below 20/200 in 27%(4/15), 20/200 or better in 73%(11/15) and 20/63 or better in 47%(7/15) with an improvement of >3 lines in 13%(2/15), no change in 27%(4/15) and a decrease of >3 lines in 60%(9/15). At the final follow-up examination, all lesions were located subfoveally. Visual acuity was below 20/200 in 47%(7/15), 20/200 or better in 53%(8/15) and 20/63 or better in 13%(2/15) with a change in visual acuity between +2 and-18 lines (mean-9 lines,median -8 lines). No change was noted in 7%(1/15) and a decrease of >3 lines in 93%(14/15) of eyes. The maximum measured greatest linear dimension of the lesion during the follow-up varied between 2400 μm and 6200 μm (mean 3680 μm, median 3600 μm) with an increase in the lesion size compared with baseline values between ±0 μm and +3700 μm (mean+1420 μm, median+1500 μm). Conclusion: PDT for CNV associated with angioid streaks seemed to slow down but not prevent the progression of the disease and associated visual loss. Further modifications of the treatments parameters or a combination with other therapeutical options seem warranted for a more effective treatment of these lesions.展开更多
Introduction: The aim of this study was to analyse 1-and 2-year outcomes aft er photodynamic therapy (PDT) in clinical routine outside of the TAP [treatment of age-related macular degeneration (AMD) with PDT] study. W...Introduction: The aim of this study was to analyse 1-and 2-year outcomes aft er photodynamic therapy (PDT) in clinical routine outside of the TAP [treatment of age-related macular degeneration (AMD) with PDT] study. We analysed the func tional results, possible influencing factors and the rate of side effects. Metho ds: We analysed the medical records of 210 consecutive patients between 50 and 9 3 years of age (73±9 years) who had been treated with PDT for active ≥50%clas sic CNV resulting from AMD. Only patients with a minimum follow-up of 1 year (1 27) were included; 52 patients completed 2 years of follow-up. Juxta-and extra foveal CNV were also analysed. Treatment was given in accordance with TAP parame ters and regular follow-up examinations were performed with standardised ETDRS visual acuity (VA) measurements and fluorescein angiography. Results: In the sub foveal group, in 63.6%(70/110) a loss of VA ≥3 lines could be prevented after 1 year, and in 51.1%(23/45) after 2 years. An improvement of ≥1 line was found in 31.8%(1 year) and in 22.2%of eyes (2 years). Severe VA loss of ≥6 lines o ccurred in 10.9%of cases after 1 year and in 15.6%after 2 years. Themean chang e of VA was-1.7±3.4 lines (1 year) and-2.5±3.9 lines (2 years). For the grou p ofCNV with juxta-/extrafoveal localisation, themean change ofVAwas +0.8±2.5 lines after 1 year and +1.0±4.2 lines after 2 years. With regard to different CNV localisations, the results for juxta-/extrafoveal CNV are statistical sign ificantly better (p=0.005 and p=0.035 after 1 and 2 years, respectively). A mean of 2.6 treatments were performed in the first year and 0.5 in the second year. Conclusions: The results obtained in a single institution compare favourably wit h the results of the TAP study. The results regarding functional visual outcome could be obtained with a lower number of treatments in clinical practice. Juxta -and extrafoveal CNV showed significantly better results than a subfoveal local isation of the CNV. In this subgroup a mean improvement of VA could be obtained after 1 or 2 years.展开更多
文摘Background: Choroidal neovascularisations (CNV) is themajor cause of significant visual loss in patients with angioid streaks. We evaluated the functional and morphological outcome of Verteporfin photodynamic therapy (PDT) in the treatment of these patients. Methods: This was a retrospective study in two tertiary referral centres over a 3-year period. Examinations included visual acuity assessment with ETDRS charts, binocular fundoscopy and fluorescein angiography. PDT was performed with standard parameters; earlier retreatments were feasible in activeCNV. Results: Fifteen eyes from 12 patients (9 male, 3 female) with a follow-up of 12-50 months (mean 26.1, median 19 months) were included. Five lesions were extraor juxtafoveal and ten were subfoveal. Baseline visual acuity was between 20/63 and 20/16 (mean 20/32, median 20/32). Eyes were treated with two to eight treatments of PDT (mean 4.2, median 4). Treatment intervals were between 5.6 and 72 weeks (mean 12.1, median 9.2 weeks). At the 1-year followup, visual acuity was below 20/200 in 27%(4/15), 20/200 or better in 73%(11/15) and 20/63 or better in 47%(7/15) with an improvement of >3 lines in 13%(2/15), no change in 27%(4/15) and a decrease of >3 lines in 60%(9/15). At the final follow-up examination, all lesions were located subfoveally. Visual acuity was below 20/200 in 47%(7/15), 20/200 or better in 53%(8/15) and 20/63 or better in 13%(2/15) with a change in visual acuity between +2 and-18 lines (mean-9 lines,median -8 lines). No change was noted in 7%(1/15) and a decrease of >3 lines in 93%(14/15) of eyes. The maximum measured greatest linear dimension of the lesion during the follow-up varied between 2400 μm and 6200 μm (mean 3680 μm, median 3600 μm) with an increase in the lesion size compared with baseline values between ±0 μm and +3700 μm (mean+1420 μm, median+1500 μm). Conclusion: PDT for CNV associated with angioid streaks seemed to slow down but not prevent the progression of the disease and associated visual loss. Further modifications of the treatments parameters or a combination with other therapeutical options seem warranted for a more effective treatment of these lesions.
文摘Introduction: The aim of this study was to analyse 1-and 2-year outcomes aft er photodynamic therapy (PDT) in clinical routine outside of the TAP [treatment of age-related macular degeneration (AMD) with PDT] study. We analysed the func tional results, possible influencing factors and the rate of side effects. Metho ds: We analysed the medical records of 210 consecutive patients between 50 and 9 3 years of age (73±9 years) who had been treated with PDT for active ≥50%clas sic CNV resulting from AMD. Only patients with a minimum follow-up of 1 year (1 27) were included; 52 patients completed 2 years of follow-up. Juxta-and extra foveal CNV were also analysed. Treatment was given in accordance with TAP parame ters and regular follow-up examinations were performed with standardised ETDRS visual acuity (VA) measurements and fluorescein angiography. Results: In the sub foveal group, in 63.6%(70/110) a loss of VA ≥3 lines could be prevented after 1 year, and in 51.1%(23/45) after 2 years. An improvement of ≥1 line was found in 31.8%(1 year) and in 22.2%of eyes (2 years). Severe VA loss of ≥6 lines o ccurred in 10.9%of cases after 1 year and in 15.6%after 2 years. Themean chang e of VA was-1.7±3.4 lines (1 year) and-2.5±3.9 lines (2 years). For the grou p ofCNV with juxta-/extrafoveal localisation, themean change ofVAwas +0.8±2.5 lines after 1 year and +1.0±4.2 lines after 2 years. With regard to different CNV localisations, the results for juxta-/extrafoveal CNV are statistical sign ificantly better (p=0.005 and p=0.035 after 1 and 2 years, respectively). A mean of 2.6 treatments were performed in the first year and 0.5 in the second year. Conclusions: The results obtained in a single institution compare favourably wit h the results of the TAP study. The results regarding functional visual outcome could be obtained with a lower number of treatments in clinical practice. Juxta -and extrafoveal CNV showed significantly better results than a subfoveal local isation of the CNV. In this subgroup a mean improvement of VA could be obtained after 1 or 2 years.
