Improvement in Quality of Life From Photodynamic Therapy: A Canadian Perspective

Can J Ophthalmol. 2001 Oct;36(6):332-8. doi: 10.1016/s0008-4182(01)80120-4.

Abstract

Background: The Treatment of Age-Related Macular Degeneration with Photodynamic Therapy (TAP) Study showed that at 1 year, photodynamic therapy significantly reduced the chances of severe visual loss (15 letters or greater) compared with placebo treatment in patients with "predominantly classic" subfoveal choroidal neovascularization (CNV). We performed a study to determine the expected gain in quality of life associated with photodynamic therapy for the treatment of subfoveal CNV in a Canadian cohort of patients with age-related macular degeneration.

Methods: We created a decision analysis model to determine the incremental gain in quality-adjusted life years (QALYs) associated with photodynamic therapy over placebo over a 2-year period. The analysis was conducted using efficacy data derived from the TAP Study and patient-based utilities collected by means of the time trade-off technique. We conducted one-way and two-way sensitivity analyses to determine the robustness of our model. A Monte Carlo simulation was used to determine whether the observed gain in QALYs with photodynamic therapy was significant.

Results: Photodynamic therapy was associated with a relative increase in QALYs of 11.3% compared with placebo. In one-way and two-way sensitivity analyses, the relative increase in quality of life associated with photodynamic therapy ranged from 4.2% to 25.7%. The Monte Carlo simulation showed that the gain in QALYs conferred from photodynamic therapy was statistically significant (p < 0.001).

Interpretation: Photodynamic therapy improves the quality of life of Canadians with predominantly classic subfoveal CNV secondary to age-related macular degeneration.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Canada
  • Choroidal Neovascularization / drug therapy*
  • Choroidal Neovascularization / etiology
  • Cohort Studies
  • Decision Support Techniques*
  • Humans
  • Macular Degeneration / complications
  • Monte Carlo Method
  • Photochemotherapy / methods*
  • Photosensitizing Agents / therapeutic use*
  • Porphyrins / therapeutic use*
  • Quality of Life*
  • Verteporfin
  • Visual Acuity

Substances

  • Photosensitizing Agents
  • Porphyrins
  • Verteporfin