Adherence to TAP guidelines yields better PDT outcomes

Following established guidelines for photodynamic therapy in age-related macular degeneration yields better visual outcomes than not following the protocols, according to a retrospective study. Eyes that did not fit the inclusion criteria of established clinical studies, or that were not followed as closely as the eyes in those studies, fared worse than eyes that fit the study criteria and were followed according to study guidelines, investigators found.

Rohan Essex and colleagues at the Royal Victorian Eye & Ear Hospital in Melbourne, Australia, reviewed the charts of 123 eyes with AMD that had been treated with verteporfin photodynamic therapy (PDT). The eyes were classified into three groups. Those who would have been eligible for the Treatment of Age-Related Macular Degeneration with PDT study (TAP), with visual acuity between 6/12 and 6/60 and predominantly classic subfoveal choroidal neovascularization (CNV), were classified as TAP comparable. Those who would have been eligible for the Verteporfin in PDT study (VIP), with occult but no classic subfoveal CNV and VA better than 6/36, were classified as VIP comparable. Patients who fell outside the inclusion criteria for the TAP and VIP studies were classified as PDT-ineligible Follow up was 12 months.

Fourteen of the 123 eyes had non-AMD related CNV; 109 eyes had AMD. Of the 109 AMD-related lesions, 72 were TAP comparable, six were VIP comparable and 31 were PDT ineligible. At the last follow-up, 36 TAP-comparable eyes (50%) had the same or improved vision, compared to 13 (42%) of the PDT-ineligible eyes.

The study is published in Clinical and Experimental Ophthalmology.