La phototherapie dynamique de la degenerescence maculaire liee a l'age avec ou sans therapie aux antioxydants.(Photodynamic therapy for age related macular degeneration with and without antioxidants)

摘要

BACKGROUND: Antioxidants may affect the lipid components of membrane receptors. The purpose of this study was to determine whether treatment with antioxidants after photodynamic therapy for age-related macular degeneration (AMD) improves visual acuity recovery time after a flicker test METHODS: The study was conducted in a university-affiliated ophthalmology clinic in Bologna, Italy, from April 2000 to April 2001. Thirty-five patients (21 men and 14 women aged 55 to 86 years [mean 72 (standard deviation [SD] 8.4) years]) with bilateral AMD and neovascular membranes were enrolled in the study. Patients were randomly assigned to either receive (20 patients) or not receive (15 patients) vitamin E (200 mg/d given orally) and polyunsaturated fatty acids (1,000 mg/d given orally) after photodynamic therapy. The outcome measures were visual acuity (logMAR) after 20, 40 and 60 days, and retinal metabolic function, as evidenced by visual acuity recovery after the Magder flicker test. RESULTS: There was no significant difference in visual acuity between the two groups at 20, 40 or 60 days. At 20 days, the visual acuity recovery time was significantly shorter in the group that received antioxidants than in the group that received photodynamic therapy only (phase II .94 [SD 0.39] minutes vs. 2.56 [SD 0.57] minutes, phase II 2.13 [SD 0.68] minutes vs. 2.83 [SD 0.60] minutes, and phase III 2.19 [SD 0.70] minutes vs. 2.92 [SD 0.65] minutes) (p < 0.001). There was no significant difference between the two groups at 40 or 60 days. INTERPRETATION: Treatment with antioxidants after photodynamic therapy for AMD improves retinal metabolic function in the short term but not in the medium term.