Purpose: Photodynamic therapy (PDT) potentially offers a novel approach to treat choroidal neovascularization (CNV) selectively without causing additional retinal damage. PDT is evaluated in a multi-center phase I/II clinical trial in patients with subfoveal CNV. Visual acuity, clinical and angiographic findings are analysed and results of different groups are summarized. Methods: Liposanal benzoporphyrin derivative monoacid A (BPD, verteporfin) was delivered intravenously at a drug dose of 6 mg/m2 or 12 mg/m2. Light exposures of 50, 75, 100 and 150 J/cm2 were applied at 20 or 30 minutes post-injection. Photoactivation was performed via a diode laser / slit lamp system emitting at 692 nm and 603 mW/cm2. PDT-effects were documented by fundus photography, angiography and monitoring of visual acuity pre PDT and one week, one and three months post PDT according to standard MPS criteria. Results: 63 patients with subfoveal CNV received a single BPD-PDT treatment. Partial closure of CNV was demonstrated in all lesions post PDT. Irradiation 20 min. post inj. yielded a rate of 66% to 100% complete closures at one week. Metamorphoosia and leakage was significantly reduced in all patients while the mean visual acuity remained stable with +0,42 (+1,57) lines. Areas of local persistence or recurrence enlarged only slowly during follow-up. Occlusion was seen in areas of classic as well as occult CNV. Conclusion: In a pilot study selective occlusion of CNV by PDT was achieved in the majority of patients at least partially, while preserving visual acuity. Appropriate parameters to obtain complete remission of CNV have to be defined in a subsequent phase of the clinical trial.
|Investigative Ophthalmology and Visual Science
|Published - Feb 15 1996
ASJC Scopus subject areas
- Sensory Systems
- Cellular and Molecular Neuroscience