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Optical coherence tomography guided retreatment of photodynamic therapy
  1. I Krebs1,2,
  2. S Binder1,2,
  3. U Stolba1,2,
  4. K Schmid2,
  5. C Glittenberg2,
  6. W Brannath3,
  7. A Goll3
  1. 1Department of Ophthalmology Rudolf Foundation Clinic, Juchgasse 25, A-1030 Vienna, Austria
  2. 2The Ludwig Boltzmann Institute of Retinology and Biomicroscopic Laser Surgery, Vienna, Austria
  3. 3Department of Medical Statistics, University of Vienna, Vienna, Austria
  1. Correspondence to: Dr I Krebs Department of Ophthalmology, Rudolf Foundation Clinic, Juchgasse 25, 1030 Vienna, Austria; Ilse.Krebswienkav.at

Abstract

Aim: To evaluate the results of a retreatment modality of photodynamic therapy (PDT) based on optical coherence tomography (OCT) and fluorescein angiography (FA). To quantify the effect of PDT with the help of measurement of the retinal thickness.

Methods: Eyes with predominantly classic subfoveal choroidal neovascularisation (CNV) due to age related macular degeneration were included. PDT was performed every three months, when needed. OCT, FA, and measures of distance acuity were performed at baseline, after 6 weeks, 3 months, and from then on every 3 months. A control group of a consecutive series of eyes that had been retreated based only on FA results was installed.

Results: Forty eyes of 38 patients were included. The average age was 73 years. The maximum retinal thickness decreased from 404 μm at baseline to 281.6 μm at month 12. Furthermore there was a significant decrease of retinal thickness in both subgroups. The number of retreatments was reduced, when activity was diagnosed using OCT and FA. (2.4 v 4.0). The distance acuity correlated significantly with the maximum retinal thickness (p = 0.0042).

Conclusion: Information about the activity of a neovascular lesion can be obtained with the help of OCT. The retreatment modalities can be optimised by using OCT and FA and the number of retreatments can be reduced.

  • CNV, choroidal neovascularisation
  • FA, fluorescein angiography
  • OCT, optical coherence tomography
  • PDT, photodynamic therapy
  • RPE, retinal pigment epithelium
  • optical coherence tomography
  • photodynamic therapy
  • choroidal neovascularisation
  • CNV, choroidal neovascularisation
  • FA, fluorescein angiography
  • OCT, optical coherence tomography
  • PDT, photodynamic therapy
  • RPE, retinal pigment epithelium
  • optical coherence tomography
  • photodynamic therapy
  • choroidal neovascularisation

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Footnotes

  • Competing interests: none declared

  • Ethics approval: the study was approved by the Institutional Review Board of the Rudolf Foundation Clinic. An informed consent was obtained from all patients.