Photodynamic therapy in age-related macular degeneration with subfoveal choroidal neovascularization

Yıl 2018, Cilt: 15 Sayı: 3, 194 - 198, 12.12.2018

Fatih Mehmet Adıbelli Michael Halpert

Öz

Backround: The aim of this study is to investigation of the efficacy of photodynamic therapy (PDT) with verteporfin (Visudyne) and nonthermal diode laser in patients with subfoveal choroidal neovascular membrane (CNVM) on the basis of age-related macular degeneration (AMD).

Material and Methods: Patients who underwent PDT with verteporfin for subfoveal CNV due to age-related macular degeneration were included in the study. The patients were divided into two groups as the first group with classic CNVM and the second group with occult CNVM. Before and after the treatment, ocular examination of the cases with biomicroscopy was performed, fundus fluorescein angiography (FFA), visual acuity and systemic risk factors were determined. Verteporphyrin at a concentration of 2 mg / ml was given intravenously in 5% dextrose. After 15 minutes of intravenous drug administration, the non-thermal diode laser beam at a wavelength of 689 nm was applied at a dose of 50 J / cm2 for 83 seconds.

Results: A total of 37 eyes of 34 patients were included in this study. The mean age of the patients was 71.62 ± 5.2 years. Sixteen (47.05%) of the cases were female and 18 (52.94%) were male. There were only 18 eyes in the first group with classic CNVM and 19 eyes in the second group with occult CNVM. The mean ages were 71.50± 4.91 in the first group and 71.73± 5.75 in the second group. Visual acuity was increased in 3 eyes (16.6%) and in 4 eyes (21%) in Group 2. There was no systemic complication except for backache in 2 patients.

Conclusions: Photodynamic therapy with verteporfin may be an effective method in the treatment of subfoveal classic CNVM and occult type CNVM associated with AMD.

Anahtar Kelimeler

Photodynamic therapy, Verteporfin, Age-related macular degeneration, Choroidal neovascular membrane

Subfoveal koroid neovaskülarizasyonlu yaşa bağlı maküla dejenerasyonunda fotodinamik tedavi uygulaması

Öz

Amaç: Yaşa bağlı makula dejenerasyonu (YBMD) zemininde gelişen subfoveal koroidal neovasküler membranlı (KNVM) olgularda verteporfin (Visudyne) ve non-termal diod lazer ile yapılan fotodinamik tedavinin (FDT) etkinliğinin araştırılması.

Materyal ve Metod: Yaşa bağlı maküla dejenerasyonuna bağlı olarak gelişen subfoveal KNVM için verteporfin ile FDT uygulanan hastalar çalışmaya dahil edildi. Olgular klasik KNVM’si olan olgular 1. grup ve gizli KNVM’si olan olgular ise 2. grup olmak üzere iki gruba ayrıldılar. Tedavi öncesi ve sonrasında olguların biyomikroskop ile oküler muayeneleri yapıldı, fundus floresein anjiografileri (FFA), görme keskinlikleri ve sistemik risk faktörleri belirlendi. 2 mg/ml’lik konsantrasyondaki Verteporfirin %5 dekstroz içersinde intravenöz olarak verildi. İntravenöz ilaç uygulanmasından 15 dk.sonra, 689 nm dalga boyundaki non-termal diod lazer ışını 50 J/cm2 dozunda 83 saniye uygulandı.

Bulgular: Toplamda 34 hastanın 37 gözü çalışmaya dâhil edildi. Tüm olguların yaş ortalaması 71,62±5,2 olarak bulundu. Olguların 16 ‘sı (%47,05) kadın, 18’i (% 52,94) erkek idi. Sadece klasik KNVM’si olan 1.grupta 18 göz, sadece gizli KNVM’si olan 2. grupta 19 göz bulunuyordu. Ortalama yaşlar 1. grupta 71,50± 4,91, 2.grupta 71,73± 5.75 idi. Tedavi sonrasında görme keskinliklerinde 1.grupta 3 gözde (% 16,6) 2. Grupta 4 gözde (% 21) artış görüldü. 2 hastada bel ağrısı dışında herhangi bir sistemik komlikasyon gelişmedi.

Sonuç: Verteporfirin ile fotodinamik tedavi YBMD zemininde gelişen subfoveal klasik tip KNVM’ların ve gizli tip KNVM’ların tedavisinde etkin bir yöntem olarak tercih edilebilir.

Anahtar Kelimeler

Fotodinamik tedavi, Verteporfin, Yaşa bağlı maküla dejenerasyonu, Koroidal neovasküler membran

Kaynakça

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