Observational prospective study of the effectiveness in routine clinical practice of verteporfin photodynamic therapy in patients with neovascular age-related macular degeneration

Aims: To investigate effectiveness in routine clinical practice of verteporfin photodynamic therapy (PDT) for neovascular age-related macular degeneration (nAMD). Patients and methods: Patients commencing PDT for nAMD in a single UK centre entered a prospective observational 7-year study and were followed for 2 years. Best-corrected visual acuity (BCVA) and contrast sensitivity (CS) were measured at each visit by accredited technicians after full protocol refraction on standardised charts. Reasons for failure to complete the course of therapy were documented. Results: 1008 patients entered the study between 1999 and 2006. 81% and 52% completed 12 and 24 months' follow-up respectively (excluding administrative censoring). Results at 12 and 24 months respectively were: maintenance of BCVA 62%, 63%; drop in mean BCVA (letters) 10.1, 9.4; numbers of treatments 2.9, 3.5. The mean CS remained stable. No correlation of change in BCVA outcome between first and second treated eyes in 82 bilateral cases was detected. Loss to follow-up was significantly associated with age, CS and distance from the treating centre. Conclusions: PDT delivered in clinical practice is at least as effective as that reported in randomised clinical trials and uses fewer treatments.