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2-year-results of Photodynamic Therapy (PDT) for 55 Patients with Age-related Macular Degeneration
Mörchen M., Ungerechts R., Emmerich K.-H.,
Städtische Kliniken Darmstadt, Augenklinik (Darmstadt)
Purpose: In the eye-clinic Darmstadt, a PDT was carried out on 91 patients from 02/00 to 02/02 on the basis of an age-related macular-degeneration. The patients, with whom a PDT was started in the time period from 02/00 to 03/01 were evaluated (n = 55 patients). The individual therapy-course will be demonstrated by selected cases.
Method: The following parameters were derived from the first and following examinations: Ophthalmologic and general anamnesis, visual acuity, examination of metamorphopsia and central skotoma by means of Amsler`s chart, measurement of an existing macular edema by ultrasonography in the sagittal section (B-mode) and classification of the AMD by fluorescein-angiographic means into following subgroups: Predominantly classic, mixed and occult CNV. The technical implementation of the PDT took place according to the protocols of the TAP-studies. Control examinations took place after three months.
Results: Out of 55 patients, 16 patients showed a classic CNV, 27 patients mixed CNC and 12 patients occult CNV. Results of the patients with classic CNV: 50% stabilization or amelioration of visual acuity; reduction of macular edema from 0,65mm to 0,25mm; reduced fluoresceinleakage with 50-62,5% after each treatment; stabilization or amelioration of the metamorphopsias with 92,8-93,8% after each treatment. Mixed CNV: 53% stabilization or amelioration of visual acuity; reduction of macular edema from 0,72 to 0,41mm; reduced fluoresceinleakage with 76-91%; stabilization or amelioration of the metamorphopsias 83-90%. Occult CNV: 64% stabilization or amelioration of visual acuity; reduction of macular edema from 0,71 to 0,35mm; reduced fluoresceinleakage with 87-91%; stabilization or amelioration of metamorphopsias 83,3-100%.
Conclusions: Patients with classic, mixed and occult CNV can profit from the PDT if an active CNV is present. The results of the TAP- and VIP-studies are confirmed in the clinical application. The B-mode-echographie proves to be a simple and feasible aid to the clinical course of observation.