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

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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., Grieve, R., Patton, W. P., Muldrew, K. A., Peto, T., Chakravarthy, U. (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