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Photodynamische Therapie mit Verteporfin bei Patienten mit idiopathischer chorioidaler Neovaskularisation

2-Jahres-Ergebnisse

Photodynamic treatment with verteporfin for patients with idiopathic choroidal neovascularization

Two-year results

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Zusammenfassung

Hintergrund

Ziel dieser Studie ist die Evaluation der photodynamischen Therapie (PDT) hinsichtlich ihrer Sicherheit und Effektivität bei der Behandlung idiopathischer chorioidaler Neovaskularisationen (CNV).

Methoden

Es wurde eine retrospektive Analyse von 11 Augen bei 9 Patienten durchgeführt, die wegen einer idiopathischen CNV mit einer PDT nach Standardparametern behandelt wurden. Die Nachbeobachtungszeit betrug mindestens ein Jahr. Es wurden regelmäßig standardisierte ETDRS-Visuserhebungen und Fluoreszenzangiographien durchgeführt.

Ergebnisse

Es wurden 8 subfoveale und 3 juxtafoveale CNV behandelt. Die mittlere Nachbeobachtungszeit betrug 23,2 Monate (12–41 Monate), die mittlere Visusveränderung +2,1 Linien (+3 bei juxtafovealer und +1,9 bei subfovealer Lage) wobei im Mittel 1,9 Behandlungen (1–3) durchgeführt wurden. Bei 6 von 11 Augen (54,5%) stieg der Visus um ≥2 Linien an, bei 5 Augen (45,5%) blieb er stabil (±1 Linie). Veränderungen des retinalen Pigmentepithels (RPE) mit Fensterdefekten in der Fluoreszenzangiographie bei 7 von 11 Augen (63,6%) blieben ohne Einfluss auf den Visus. In 4 von 11 Fällen (36,4%) trat nach initial erfolgreicher Therapie ein Rezidiv auf, welches erfolgreich mit PDT behandelt wurde.

Schlussfolgerung

Durch die PDT ist bei der Behandlung idiopathischer CNV eine Visusverbesserung bzw. -stabilisierung möglich. Nebenwirkungen wie RPE-Veränderungen und Rezidive treten auf, scheinen aber nicht visusrelevant zu sein.

Abstract

Background

The aim of this study was the evaluation of safety and effectiveness of photodynamic therapy (PDT) as a treatment option for idiopathic choroidal neovascularization (CNV).

Methods

We performed a retrospective analysis of 11 eyes of 9 patients who were treated with standard PDT. The follow-up period was at least 1 year and included regular standardized ETDRS visual acuity measurement and fluorescein angiography.

Results

Eight sub- and three juxtafoveal CNV were treated. The mean follow-up was 23.2 months (12–41 months), the mean change in visual acuity was +2.1 lines (+3 for juxtafoveal and +1.9 for subfoveal localization), and a mean of 1.9 (1–3) treatments were performed. Visual acuity improved ≥2 lines in 6 of 11 eyes (54.5%) and 5 eyes (45.5%) remained stable (±1 lines). Alterations of the retinal pigmented epithelium (RPE) with window defects in fluorescein angiography occurred in 7 of 11 eyes (63.6%) but did not alter visual acuity. In 4 of 11 cases (36.4%), we saw recurrences after initially successful therapy, which were retreated successfully with PDT.

Conclusion

Stabilization or even an improvement of visual acuity in idiopathic CNV is possible with PDT treatment. Side effects such as RPE changes and recurrences are possible, but do not seem to influence visual acuity.

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Authors and Affiliations

  1. Augenklinik, Universitätsklinikum Benjamin Franklin der Freien Universität Berlin

    J. Wachtlin, A. Wehner, H. Heimann & M. H. Foerster

  2. Augenklinik, Universitätsklinikum Benjamin Franklin der Freien Universität Berlin, Hindenburgdamm 30, 12200, Berlin

    J. Wachtlin

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  1. J. Wachtlin
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  2. A. Wehner
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  3. H. Heimann
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  4. M. H. Foerster
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Correspondence to J. Wachtlin.

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Wachtlin, J., Wehner, A., Heimann, H. et al. Photodynamische Therapie mit Verteporfin bei Patienten mit idiopathischer chorioidaler Neovaskularisation. Ophthalmologe 101, 489–495 (2004). https://doi.org/10.1007/s00347-004-0993-5

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  • DOI: https://doi.org/10.1007/s00347-004-0993-5

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