タカハシ　カンジ   TAKAHASHI KANJI   髙橋　寛二    所属   関西医科大学  眼科学講座    職種   非常勤講師
言語種別
発表タイトル	Long-term results of modified PDT procedure (Ironing PDT) for AMD patients with large lesion
会議名	第51回　日本網膜硝子体学会総会
発表者・共同発表者	◎Otsuji T, Sho K, Tsumura A, Koike N, Tsuda M, Nishimura T, Takahashi K
発表年月日	2012/11
開催地 （都市, 国名）	山梨
概要	Purpose: We previously reported intravitreal anti-Vascular endothelial growth factor (VEGF) therapy was not effective for about 10% of the patients with exudative age-related macular degeneration (AMD). For those patients (non-responder), we usually choose photodynamic therapy (PDT) but it is sometimes impossible to cover a large lesion. We investigate the long-term efficacy of the modified PDT procedure for those cases. Methods: We observed 9 eyes of 9 patients with a minimum of 24 months follow-up. We chose PDT because anti-VEGF therapy was not effective for them or they had histories of cardiovascular disease. We performed PDT by moving the PDT laser spot at a constant speed for 83 seconds to cover the whole lesion when the lesion could not be covered by the ordinary use of PDT either because the lesion was too large or too close to the optic disc (We named this procedure Ironing PDT). Their average age was 74.9 years. Four eyes were typical AMD and 5 eyes were polypoidal choroidal vasculopathy (PCV). Results: No exudation could be found after 24 months treatment in 7 eyes, but vitreous hemorrhage occurred in one patient with PCV. The average number of PDT sessions per patient was 1.6. The best-corrected visual acuity (BCVA) was maintained because it was 0.11 before PDT and 0.09 after treatment. The BCVA of 7 eyes improved and that of 2 eyes deteriorated if we define an increase or decrease of ≧ 0.3 logMAR lines as significant. Conclusion: Moving the laser spot made the irradiation time shorter at each spot, but the exudation could be suppressed for a long time. Ironing PDT is effective for AMD patients because it can cover the whole lesion without excessive irradiation.