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Recurrence of choroidal neovascularisation after photodynamic therapy in patients with age-related macular degeneration


Aim: To determine the incidence of recurrence of choroidal neovascularisation (CNV) 18 months after cessation of photodynamic therapy (PDT) with verteporfin monotherapy in patients with age-related macular degeneration (AMD).

Methods: This was a prospective interventional cohort study. The sample consisted of 108 individuals with CNV secondary to AMD which was treated with PDT. Data on demographics, pre-PDT and post-PDT Early Treatment of Diabetic Retinopathy Study (ETDRS) acuity, pre-PDT lesion size and composition were collected for each participant. All participants returned for fundus photographs and ETDRS acuity measurements 18 months after their final PDT, which were compared with the same measurements from the final treatment session to determine recurrence status. Recurrences were classified primarily on the basis of haemorrhage and increased lesion size.

Results: Recurrences were observed in 36 of 108 (33%) eyes. 23 of 36 (64%) recurrences were clinically meaningful. Of the explanatory variables considered, only final PDT acuity was significantly different between those that recurred (45.5 ETDRS letters) and those that did not (38.4 letters; p = 0.03).

Conclusion: CNV recurrences are common after PDT for AMD, occurring in 33% of eyes in this study. Visual acuity measured at the final PDT treatment visit may be a predictor of subsequent recurrence.

  • AMD, age-related macular degeneration
  • CNV, choroidal neovascularisation
  • ETDRS, Early Treatment of Diabetic Retinopathy Study
  • FA, fluorescein angiography
  • MC, minimally classic
  • MPS, Macular Photocoagulation Study
  • OC, occult
  • PC, predominantly classic
  • PDT, photodynamic therapy
  • VEGF, vascular endothelial growth factor

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