Short-term comparison of photodynamic and transpupillary therapy for choroidal neovascularization

Abstract

Objective To compare the clinical results of photodynamic and transpupillary thermotherapy for macular diseases with choroidal neovascularization.Methods 97 cases (101 eyes) with exudative AMD, idiopathic CNV, pathologic myopia and fundus steak second CNV were divided into PDT and TTT groups. 52 cases (54eyes) were treated with PDT and 45 cases (47eyes) with TTT.BCVA,FFA,OCT and ICG were evaluated before and after treatment within one or three months.Results Visual acuity of PDT group and TTT group followed up 1or3 months increased at least 2 lines was no difference(X2=0.27,p>0.05,X2=0.034,p>0.05).Visual acuity in 25 eyes(46.2%),20 eyes(37%) of PDT group and 14 eyes (29.8%),16eyes (34%) of TTT group increased or unchanged.the difference was significant (X2=3.96,p<0.05) followed 1 month.But the difference was no significant followed up 3 months.Visual acuity in 40%,54% eyes with Classic CNV or predominantly CNV of PDT groups increased at 2 lines followed 1-3 months,however 12.5%,12.5% in TTT groups.The difference was significant (X2=7.57,p<0.01,X2=4.14,p<0.05).visual acuity of occult CNV no matter how PDT groups or TTT groups was no significant difference followed-up 1to 3 months.FFA showed cessation or reduction of fluorescein leakage from CNV in PDT groups was better than TTT groups followed-up 1 month.(X2=6.64,p<0.05),there was no significant difference followed-up 3 months.Conclusion For classic CNV,the short-term effect of PDT is better than TTT concerning visual acuity.The effect of PDT is apparently better than TTT in cessation or reduction of fluorescin leakage 1 to 3 months after treatment.For occult CNV,there is no significant short-term difference between monoPDT and momoTTT concerning visual acuity.We need more cases and long follow-up to evaluate combined two kinds of treatments in treating CNV. Key words: Macular diseases; Choroidal neovasculation; Photodynamic therapy; Transpupillarythermo therapy