Laser treatments with verteporfin therapy and its potential impact on retinal practices

Background: In the 1990s, the only available treatment for neovascular age- related macular degeneration (ARMD) was laser photocoagulation, bur a minor ity of patients could be treated. Photodynamic therapy with verteporfin pot entially allows many more patients to be treated. The authors' aim was to a ssess the impact of this increase on retinal practices. Methods: The number of patients who received laser photocoagulation in 1998 was determined. Based on that number and a retrospective review of 1000 co nsecutive records of new patients with ARMD referred to the Associated Reti nal Consultants practices during 1998, estimates were made of how many pati ents would have been eligible for verteporfin therapy. Results: Of the 1000 patients, 171 had predominantly classic subfoveal chor oidal neovascularization secondary to ARMD and would have been eligible for verteporfin therapy, compared with 99 treated with laser photocoagulation according to Macular Photocoagulation Study guidelines. If this patient pop ulation is representative of the general population, approximately 84,000 p atients would be eligible for verteporfin therapy in the United States per year, compared with 42,000 for laser photocoagulation. This would lead to 2 86,000 verteporfin treatments per year if retreatments are required. Conclusions: This increase in treatments for neovascular ARMD will have a c onsiderable impact on retinal practices. Although the resources that will n eed to be expended are high, the potential benefit of verteporfin therapy i n reducing vision loss will outweigh the costs.