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The effect of the first application of verteporfin photodynamic therapy on lesion growth in choroidal neovascularisation and its potential impact on combination therapy.
- Source :
-
Clinical & experimental optometry [Clin Exp Optom] 2009 Sep; Vol. 92 (5), pp. 440-3. Date of Electronic Publication: 2009 Jun 22. - Publication Year :
- 2009
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Abstract
- Purpose: To evaluate the impact of lesion size on the observed growth of the choroidal neovascularisation (CNV) following the first application of photodynamic therapy (PDT).<br />Methods: A retrospective study of consecutive patients with subfoveal classic CNV or predominantly classic CNV undergoing first verteporfin photodynamic therapy (VPDT) according to treatment of age-related macular degeneration with photodynamic therapy (TAP) protocol between June 2005 and September 2005. Patients were classified into two groups according to baseline greatest linear dimension (GLD) at the time of VPDT monotherapy. Group 1 comprised patients with lesion GLD less then 2000 microm and Group 2, patients with lesion GLD 2000 microm or larger. Difference between the mean GLD at baseline and at three months post-treatment were investigated for clinical significance using the paired t-test.<br />Results: Group 1 (n = 16) showed a mean change in GLD from 1380.25 microm to 2031.25 microm, while Group 2 (n = 26) showed a mean change of 2909.26 microm to 3023.07 microm. Data of mean percentage change in GLD for Group 1 showed a 51.97 per cent increase in the lesion size [95% CI, 22.93 - 81.01%] in comparison to Group 2, which showed only 5.8 per cent increase in the lesion [95% CI, -9.65 - 21.61%]. Comparison of the mean percentage change in GLD between the two groups showed a statistically significant difference (p = 0.003).<br />Conclusions: Our study demonstrates that following the first application of VPDT, smaller lesions enlarge disproportionately more than larger lesions. As we have entered into the era of using angiostatic agents in combination with VPDT, it may be important to evaluate this effect with regards to the timing of VPDT commencement.
- Subjects :
- Aged
Aged, 80 and over
Female
Fovea Centralis drug effects
Fovea Centralis pathology
Humans
Male
Middle Aged
Retrospective Studies
Treatment Outcome
Verteporfin
Choroidal Neovascularization drug therapy
Choroidal Neovascularization pathology
Photochemotherapy
Photosensitizing Agents therapeutic use
Porphyrins therapeutic use
Subjects
Details
- Language :
- English
- ISSN :
- 1444-0938
- Volume :
- 92
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- Clinical & experimental optometry
- Publication Type :
- Academic Journal
- Accession number :
- 19552669
- Full Text :
- https://doi.org/10.1111/j.1444-0938.2009.00403.x