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Impressum
Optical Coherence Tomography (OCT) in the management of photodynamic therapy (pdt) foveal thickness and visual acuity after twelve months follow-up
Lackerbauer C.-A., Ullrich S., Gandorfer A., Thiel M. J., Hoops J. P.
Department of Ophthalmology, Ludwig-Maximilians-University, Mathildenstr. 8, D-80336 München
Purpose: To evaluate the temporal response of foveal thickness
and visual acuity to photodynamic therapy (Visudyneâ ) using OCT.
To correlate changes in foveal thickness with visual acuity.
Method: 24 patients were diagnosed with predominantly classic subfoveal
choroidal neovascularization secondary to age-related macular degeneration.
Each qualified for PDT by angiographic characteristics, visual acuity
and lesion size. All patients were treated with PDT according to the standard
protocol. Pre-treatment combined fluoresceinindocyaningreen angiographic
as well as OCT were obtained. Diagnostic parameters were revaluated after
four weeks, three-, six-, nine- and twelve months.
Results: Mean foveal thickness prior to treatment was 412µm,
visual acuity 0,82(LogMAR). At four weeks this value diminished to 317µm
(-29% from baseline) with a corresponding improvement in visual acuity
to 0,71(LogMAR). After three month follow up mean foveal thickness increased
to 366µm (-12%) and visual acuity decreased to 0,92 (LogMAR). At
six month (325µm (-26%)), nine month (308µm (-32%)) and twelve
months follow-up (275µm (-49%)) foveal thickness continuously decreased
while visual acuity droped down from 1,0 (LogMAR) at six month to 1,2
(LogMAR) at twelve months after PDT.
Conclusion: OCT results of foveal thickness correspond to the visual
acuity in the first three month after PDT. After six to twelve months
no correlation was seen, since mean foveal thickness remain below baseline
with reduced visual benefit. To our opinion this might be the result of
increased subretinal fibrosis and central retino-choroidal atrophy seen
in most of the patients.