Visudyne Therapy Effect on Functional Vision
Ronald A. Schuchard, PhD
NOVARTIS (2002 - 2004)

Purpose: To determine whether dense macular scotoma size was affected by verteporfin (Visudyne¿, Novartis AG) therapy for neovascular age-related macular degeneration (AMD) and compare effect of therapy on visual acuity and central visual field. Methods: Visual acuity was measured in 64 patients with neovascular AMD and dense scotoma determined using scanning laser ophthalmoscope (SLO) macular perimetry. Patients received verteporfin therapy and were assessed 3 months later; 29 patients were reassessed at 12 months. Results: Median best-corrected visual acuity was 20/300 before treatment, 20/250 at 3 months (62% improved or stabilized), and 20/400 at 12 months (38% improved or stabilized). At 3 months, mean scotoma area decreased (50 vs. 47.6 degrees2), 79% improved or stabilized, and mean scotoma size decreased by 5%. At 12 months, mean scotoma area was 40.1 degrees2, 69% improved or stabilized, and mean scotoma size decreased by 20%. Of those patients with worse visual acuity 12 months after treatment, 61% had significant stabilization or improvement of scotoma area. Conclusions: Macular scotoma size, important for low vision rehabilitation, stabilized or improved after verteporfin therapy in more patients than visual acuity, even in the majority of those with decreased visual acuity. This positive effect on central visual field may represent a significant benefit of verteporfin therapy, not demonstrated by previous studies that only measured visual acuity or contrast sensitivity outcomes.