Verteporfin photodynamic therapy cohort study

report 1: effectiveness and factors influencing outcomes

Simon P. Harding, Keith Tomlin, Barnaby C. Reeves, Julia Langham, Jemma Walker, James Carpenter, Richard Grieve, William P. Patton, Katherine A. Muldrew, Tunde Peto, Usha Chakravarthy,

Research output: Contribution to journalArticle

Abstract

Purpose - To compare the visual outcomes after verteporfin photodynamic therapy (VPDT) administered in routine clinical practice with those observed in the Treatment of Age-related macular degeneration with Photodynamic therapy (TAP) trials and to quantify the effects of clinically important baseline covariates on outcome.

Design - A prospective longitudinal study of patients treated with VPDT in 45 ophthalmology departments in the United Kingdom with expertise in the management of neovascular age-related macular degeneration (nAMD).

Participants - Patients with wholly or predominantly classic choroidal neovascularization (CNV) of any cause with a visual acuity =20/200 in the eye to be treated.

Methods - Refracted best-corrected visual acuity (BCVA) and contrast sensitivity were measured in VPDT-treated eyes at baseline and subsequent visits. Eyes were retreated at 3 months if CNV was judged to be active. Baseline angiograms were graded to quantify the percentages of classic and occult CNV. Treated eyes were categorized as eligible or ineligible for TAP, or unclassifiable.

Main Outcome Measures - Best-corrected visual acuity and contrast sensitivity during 1 year of follow-up after initial treatment.

Results - A total of 7748 treated patients were recruited. Data from 4043 patients with a diagnosis of nAMD were used in the present analysis. Reading center determination of lesion type showed that 87% were predominantly classic CNV. Eyes received 2.4 treatments in year 1 and 0.4 treatments in year 2. Deterioration of BCVA over 1 year was similar to that observed in the VPDT arms of the TAP trials and was not influenced by TAP eligibility classification. Best-corrected visual acuity deteriorated more quickly in current smokers; with increasing proportion of classic CNV, increasing age, and better baseline BCVA; and when the fellow eye was the better eye.
Original languageEnglish
Pages (from-to)e1-8
Number of pages8
JournalOphthalmology
Volume116
Issue number12
Early online date30 Nov 2009
DOIs
Publication statusPublished - Dec 2009

Fingerprint

Photochemotherapy
Choroidal Neovascularization
Cohort Studies
Visual Acuity
Macular Degeneration
Contrast Sensitivity
Therapeutics
Ophthalmology
verteporfin
Longitudinal Studies
Reading
Angiography
Arm
Outcome Assessment (Health Care)
Prospective Studies

Keywords

  • aged
  • choroidal neovascularization
  • contrast sensitivity
  • female
  • follow-up studies
  • Great Britain
  • humans
  • macular degeneration
  • male
  • photochemotherapy
  • photosensitizing Agents
  • porphyrins
  • prospective Studies
  • state medicine
  • treatment outcome
  • visual acuity

Cite this

Harding, S. P., Tomlin, K., Reeves, B. C., Langham, J., Walker, J., Carpenter, J. (2009). Verteporfin photodynamic therapy cohort study: report 1: effectiveness and factors influencing outcomes. Ophthalmology, 116(12), e1-8. https://doi.org/10.1016/j.ophtha.2009.10.022
Harding, Simon P. ; Tomlin, Keith ; Reeves, Barnaby C. ; Langham, Julia ; Walker, Jemma ; Carpenter, James ; Grieve, Richard ; Patton, William P. ; Muldrew, Katherine A. ; Peto, Tunde ; Chakravarthy, Usha. / Verteporfin photodynamic therapy cohort study : report 1: effectiveness and factors influencing outcomes. In: Ophthalmology. 2009 ; Vol. 116, No. 12. pp. e1-8.
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Harding, SP, Tomlin, K, Reeves, BC, Langham, J, Walker, J, Carpenter, J, Grieve, R, Patton, WP, Muldrew, KA, Peto, T, Chakravarthy, U 2009, 'Verteporfin photodynamic therapy cohort study: report 1: effectiveness and factors influencing outcomes', Ophthalmology, vol. 116, no. 12, pp. e1-8. https://doi.org/10.1016/j.ophtha.2009.10.022

Verteporfin photodynamic therapy cohort study : report 1: effectiveness and factors influencing outcomes. / Harding, Simon P.; Tomlin, Keith; Reeves, Barnaby C.; Langham, Julia; Walker, Jemma; Carpenter, James; Grieve, Richard; Patton, William P.; Muldrew, Katherine A.; Peto, Tunde; Chakravarthy, Usha.

In: Ophthalmology, Vol. 116, No. 12, 12.2009, p. e1-8.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Verteporfin photodynamic therapy cohort study

T2 - report 1: effectiveness and factors influencing outcomes

AU - Harding, Simon P.

AU - Tomlin, Keith

AU - Reeves, Barnaby C.

AU - Langham, Julia

AU - Walker, Jemma

AU - Carpenter, James

AU - Grieve, Richard

AU - Patton, William P.

AU - Muldrew, Katherine A.

AU - Peto, Tunde

AU - Chakravarthy, Usha

AU - Gibson, Jonathan

PY - 2009/12

Y1 - 2009/12

N2 - Purpose - To compare the visual outcomes after verteporfin photodynamic therapy (VPDT) administered in routine clinical practice with those observed in the Treatment of Age-related macular degeneration with Photodynamic therapy (TAP) trials and to quantify the effects of clinically important baseline covariates on outcome.Design - A prospective longitudinal study of patients treated with VPDT in 45 ophthalmology departments in the United Kingdom with expertise in the management of neovascular age-related macular degeneration (nAMD).Participants - Patients with wholly or predominantly classic choroidal neovascularization (CNV) of any cause with a visual acuity =20/200 in the eye to be treated.Methods - Refracted best-corrected visual acuity (BCVA) and contrast sensitivity were measured in VPDT-treated eyes at baseline and subsequent visits. Eyes were retreated at 3 months if CNV was judged to be active. Baseline angiograms were graded to quantify the percentages of classic and occult CNV. Treated eyes were categorized as eligible or ineligible for TAP, or unclassifiable.Main Outcome Measures - Best-corrected visual acuity and contrast sensitivity during 1 year of follow-up after initial treatment.Results - A total of 7748 treated patients were recruited. Data from 4043 patients with a diagnosis of nAMD were used in the present analysis. Reading center determination of lesion type showed that 87% were predominantly classic CNV. Eyes received 2.4 treatments in year 1 and 0.4 treatments in year 2. Deterioration of BCVA over 1 year was similar to that observed in the VPDT arms of the TAP trials and was not influenced by TAP eligibility classification. Best-corrected visual acuity deteriorated more quickly in current smokers; with increasing proportion of classic CNV, increasing age, and better baseline BCVA; and when the fellow eye was the better eye.

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KW - follow-up studies

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KW - macular degeneration

KW - male

KW - photochemotherapy

KW - photosensitizing Agents

KW - porphyrins

KW - prospective Studies

KW - state medicine

KW - treatment outcome

KW - visual acuity

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