Photodynamic therapy of subfoveal choroidal neovascularization using Verteporfin (Visudyne): Recent results
U. Schmidt-Erfurth and the TAP/VIP Study Group
One-year results of a prospective, randomized trial with photodynamic therapy (PDT) using verteporfin (Visudyne) in subfoveal choroidal neovascularization (CNV) have recently demonstrated that visual stabilization was achieved in the majority of PDT-treated patients. Data through two years of follow-up and a preliminary analysis of effects in occult CNV and CNV related to myopia will be available as early as in mid 2000.
Patients and methods: 609 patients demonstrating CNV with a classic component due to age-related macular degeneration (AMD) were included into the TAP-investigation and followed for two years. In the VIP-trial 450 participants were collected presenting either with early CNV and a classic portion or isolated occult CNV in AMD or eyes with CNV secondary to pathologic myopia > -6dpt. Patients were examined in three months intervals and were retreated with verteporfin or placebo, if active leakage was detected angiographically.
Results: The TAP-results revealed, that the therapeutic benefit was most pronounced, if the proportion of the classic component of the entire lesion was larger. In predominantly classic CNV mean visual loss was smaller, mean final visual acuity and contrast sensitivity score were significantly higher. Over all less treatments were necessary to achieve complete absence of leakage and the final size of the CNV lesions was smaller. In the VIP-trial positive results were documented particularly in CNV related to myopia. Recent data analysis available as of September 2000 will be presented.
Conclusion: Verteporfin therapy has provided preliminary positive results so far. For approval of the modality evidence of long-term therapeutic benefit is necessary as well as an evaluation of the potential in patients with CNV lacking a classic component.
Univ.-Augenklinik, Ratzeburger Allee 160, 23538 Lübeck