Photodynamic therapy for predominantly hemorrhagic lesions in neovascular age-related macular degeneration.

PURPOSE: To evaluate the response of eyes treated with photodynamic therapy (PDT) for predominantly hemorrhagic lesions in neovascular age-related macular degeneration (NVAMD). DESIGN: Consecutive, interventional case series. METHODS: A retrospective review was conducted of eyes with NVAMD that were treated with PDT for predominantly hemorrhagic subfoveal lesions. Baseline data recorded were patient age, use of aspirin or warfarin, history of previous PDT treatment, visual acuity (VA), extent of subretinal hemorrhage (SRH), and central foveal thickness (CFT) and total macular volume (TMV) measured by optical coherence tomography (OCT). Follow-up VA, SRH status, and complications were recorded. RESULTS: Twenty-one eyes of 21 patients were identified with a mean posttreatment follow-up of 9.4 months. Mean pretreatment VA was 20/210, and mean SRH size was 16 disk areas. The SRH resolved in 18 eyes (86%) after a mean of six months, with a mean VA of 20/210. Mean VA for all eyes at most recent follow-up was 20/250. Thirteen (62%) of 21 eyes exhibited stable or improved VA at the most recent follow-up. VA one year after PDT inversely correlated with patient age (P = .045) and initial SRH size (P = .04) and positively correlated with pretreatment VA (P = .01). Previous PDT treatment, use of aspirin or warfarin, and OCT data did not significantly correlate with VA or SRH resolution. CONCLUSIONS: PDT may be an effective treatment for minimizing visual loss in eyes with NVAMD and predominantly hemorrhagic lesions. Further study is warranted to detail the risk-benefit ratio and compare PDT with other treatment modalities.

Duke Scholars

Author Sandra Sue Stinnett Biostatistics & Bioinformatics, Division of Biostatistics

Author Sharon Fekrat Ophthalmology, Vitreoretinal Diseases & Surgery