Optimizing photodynamic therapy in the treatment of age-related Macular Degeneration

Photodynamic therapy provides the unique feature of a selective and non-invasive modality achieving an immediate and reproducible occlusion of choroidal neovascularization (CNV) with preservation of adjacent sensitive retinal structures. A clinical study phase III was just able to demonstrate that in the case of purely classic CNV vision was stabilized in 80 % of eyes for as long as one year using PDT. However, only a single indication - CNV with a classic component - a rare finding, and a single treatment protocol with multiple repetitive treatment courses were evaluated. With the first sensitizer becoming licensed and clinically available, an optimization of the photodynamic technique can be performed. Additional studies will have to determine adequate parameters to improve selectivity, reduce the rate of recurrence and the need for continuous treatment repetitions. The efficacy of PDT in occult CNV and early stages of AMD as well as the specific diagnostic measures relevant to PDT must be identified to introduce PDT as an appropriate modality in the treatment of a large population of AMD patients.