Eter N., Vogel A., Inhetvin-Hutter C., Spitznas M.

Department of Ophthalmology, University of Bonn Medical Center, Sigmund-Freud-Str. 25, D-53105 Bonn

Purpose: To evaluate the efficacy of shorter therapy and control intervals after PDT with Verteporfin in age-related, predominantly classic choroidal neovascularization (CNV).
Methods: In 16 eyes with subfoveal CNV ophthalmologic examination and fluorescein angiography were performed one (T1) and six (T2) weeks following PDT. If necessary, a second PDT was applied within one week, and patients were followed according to the prior schedule, i.e. one (T3) and six (T4) weeks after the second PDT. The size of the CNV was measured in pixels in the early frames by the angiography software.
Results: At T1 the CNV was occluded in 12 eyes and 80% smaller in the remaining 4 eyes. At T2 the CNV was perfused again in all 16 cases and only 9% smaller than before treatment. However, in 2 eyes the residual CNV was now located extrafoveally so that treatment could be completed by argon laser. The remaining 14 eyes were re-treated by PDT. At T3 the CNV was occluded in 10 eyes and 68% smaller in the other 4 eyes. At T4 the CNV was not only perfused again in all cases, but it had grown by 19 % as compared to its size prior to the first treatment. Mean visual acuity was 0.13 at the onset of treatment and 0.12 at the end of the observation period.
Conclusion: Shortening of the TAP-study-suggested treatment interval of three months does not seem to cause permanent occlusion of the CNV. Visual acuity is equally unaffected. Only bigger numbers will tell if, with a shorter treatment interval, the residual membranes will become extrafoveal in a considerable number of cases and thus accessible to argon laser treatment. The same is true for a possible increase in size of the CNV. The study is ongoing.

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