Photodynamic therapy with delayed light application for the treatment of bilateral subfoveal choroidal neovascularization in age-related macular degeneration

Purpose: To determine if photodynamic therapy (PDT) with delayed light application at 17 minutes after the start of infusion was effective in the second eyes of patients with bilateral subfoveal classic choroidal neovascularization (CNV) secondary to age-related macular degeneration (AMD). Methods: The records of 20 patients with bilateral subfoveal classic CNV secondary to AMD who were treated with bilateral PDT in the same session were reviewed. Treatment for the second eye of patients was begun 120 seconds after termination of treatment for the first eye. This time interval was necessary for applying the contact lens and entering the new laser parameters, and it was kept constant in all cases. Best-corrected visual acuity (BCVA), ophthalmologic examinations, fluorescein and indocyanine angiograms were used to evaluate the results of PDT. Follow-up time ranged from 6 to 12 months with a mean of 8.7 (+/-2.1) months. Results: Mean (+/-SD) treatment sessions were 1.7 (+/-0.6) in first eyes and 1.7 (+/-0.5) in second eyes. Among first eyes, BCVA improved in 7 of the 20 eyes (35%); stabilized in 7 eyes (35%); and worsened in 6 eyes (30%). Among second eyes, BCVA improved in 5 of the 20 eyes (25%); stabilized in 8 eyes (40%); and worsened in 7 eyes (35%). Conclusions: In most cases, bilateral PDT in the same session achieved cessation of fluorescein leakage from CNV without loss of vision or growth of CNV in the second eyes of patients with bilateral subfoveal classic CNV secondary to AMD. Further studies with I larger number of patients and longer follow-up are necessary to confirm whether bilateral PDT in the same session is beneficial for bilateral subfoveal classic CNV related to AMD. (C) 2003 Japanese Ophthalmological Society.