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Early PDT re-treatment shows no benefit over standard regimen for AMD
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Re-treatment with verteporfin photodynamic therapy at 2-month intervals did not show a significant benefit at 1 year compared with re-treatment every 3 months in patients with age-related macular degeneration, a study found.
Stephan Michels, MD, and colleagues conducted the prospective, randomized, multicenter clinical study, including 203 patients with predominantly classic choroidal neovascularization (CNV) secondary to AMD, to determine the value of early re-treatment with verteporfin PDT.
“At all follow-up visits, the re-treatment group lost less mean vision, fewer patients lost at least three lines of visual acuity, more patients gained at least one line of vision and CNV growth was less progressive,” the authors said. However, none of these differences reached statistical significance in the general study population, they said.
A subgroup analysis showed a statistically relevant benefit for patients with small lesions (greatest linear dimension less than 2,000 µm) at baseline who received early re-treatment.
The primary outcome measure in the study was best corrected mean visual acuity, and secondary outcomes measure included the percentage of patients who lost at least three lines of vision, percentage gaining one line, lesion size based on the greatest linear dimension documented by fluorescein angiography, impact of initial lesion size, and re-treatment rate, as well as safety.
Baseline mean visual acuity was 20/100 –1 for both groups. Mean visual acuity was better in the early re-treatment group at all follow-up points, but the difference did not reach statistical significance. The re-treatment group trended toward better outcomes, with 61% losing less than three lines of vision at 12 months compared with 51.7% of the standard re-treatment group.
The study is published in the December issue of Ophthalmology.