Photodynamic therapy with verteporfin for subfoveal choroidal neovascularization in age-related macular degeneration: results of an effectiveness study.

OBJECTIVE: To determine the postapproval effectiveness of photodynamic therapy (PDT) with verteporfin for the treatment of predominantly classic subfoveal choroidal neovascularization (CNV) secondary to age-related macular degeneration.

METHODS: Forty-five consecutive patients treated with PDT for subfoveal CNV were compared with an untreated historical control group. Control patients had subfoveal CNV and were first seen by us within 1 year before Health Canada's approval of verteporfin. Both groups were followed up for the development of significant visual loss, stability, or improvement. Multivariate models were constructed to evaluate the effectiveness of PDT, controlling for multiple covariates (age, sex, baseline visual acuity, follow-up time, lesion size, and number of treatments).

RESULTS: Significant differences were noted in the change in visual acuity between those who did and did not receive PDT (chi(2) = 5.9, P =.048). Patients who received PDT were 2.9 times (95% confidence interval, 0.9-9.1) less likely to develop a moderate (>2 lines) visual loss (chi(2) = 3.2, P =.07). Controlling for covariates, patients who received PDT were 13.7 times (95% confidence interval, 1.4-132.6) more likely to develop a visual improvement of at least 1 line.

CONCLUSION: Compared with historical controls, PDT was demonstrated to be effective for the treatment of predominantly classic subfoveal CNV.