Method to treat age-related macular degeneration

Abstract

Age-related macular degeneration (AMD) results in the formation of new blood vessels in the eye. The walls of these vessels leak fluid, which causes scarring in the surrounding tissue and results in reduced vision or loss of vision. Photodynamic therapy (PDT) alone has been used to treat AMD, but many retreatments are needed, which cause further damage to the already diseased area. Laser treatment to coagulate the fluid actually causes additional new vessels to form. However, the inventive method of treating patients with both PDT and scatter threshold laser coagulation therapy surprisingly either improved vision, or prevented further loss of vision. Moreover, the combined treatment eliminated the need for retreatment, and did not generate new vessel growth. Threshold laser coagulation and PDT may be administered within the same treatment session or either may be administered first and the other may be administered within ninety days.

1 . A method to reduce recurrence of neovascularization in an eye of a patient having undergone photodynamic therapy (PDT) for macular degeneration comprising further providing to said patient laser coagulation therapy simultaneously or concomitantly with PDT.  
   
   
       2 . The method of  claim 1  wherein the laser coagulation therapy is administered at a time selected from the group consisting of within a single treatment session, within four hours of PDT, within 24 hours of PDT, and ninety days after PDT.  
   
   
       3 . The method of  claim 1  wherein said PDT is administered at a time selected from the group consisting of within a single treatment session, within four hours of laser therapy, within 24 hours of laser therapy, and ninety days after laser therapy.  
   
   
       4 . The method of  claim 1  further comprising treating the patient having undergone PDT with plasmaphoresis.  
   
   
       5 . A method to reduce recurrence of neovascularization in an eye of a patient having undergone laser coagulation therapy for AMD comprising providing to said patient photodynamic therapy (PDT) simultaneously or concomitantly with laser coagulation therapy.  
   
   
       6 . The method of  claim 5  wherein said laser coagulation therapy is administered at a time selected from the group consisting of within a single treatment session, within four hours of PDT, within 24 hours of PDT, and ninety days after PDT.  
   
   
       7 . The method of  claim 5  wherein said PDT is administered at a time selected from the group consisting of within a single treatment session, within four hours of laser coagulation therapy, within 24 hours of laser photocoagulation therapy, and ninety days after laser photocoagulation therapy.  
   
   
       8 . The method of  claim 5  further comprising treating the patient with plasmaphoresis after PDT.  
   
   
       9 . A therapeutic method to slow progression of macular degeneration in a patient having or at risk for developing macular degeneration in an eye comprising treating said eye with both photodynamic therapy and laser coagulation therapy within an interval of ninety days.  
   
   
       10 . A method to minimize photosensitivity of a patient undergoing photodynamic therapy with a photosensitive agent comprising 
 providing an effective amount of the photosensitive agent to the vessels of the patient and thereafter activating the agent with a low energy light, and    thereafter treating the patient with plasmaphoresis to reduce the concentration of the photosensitive agent in the vessels of the patient.    
   
   
       11 . The method of  claim 10  wherein the patient is treated with plasmaphoresis within 24 hours of photodynamic therapy.  
   
   
       12 . A method to treat an eye of a patient having undergone photodynamic therapy (PDT) for macular degeneration comprising further providing to said patient scatter threshold laser coagulation therapy simultaneously or concomitantly with PDT.  
   
   
       13 . The method of  claim 12  wherein the threshold laser coagulation therapy is administered at a time selected from the group consisting of within a single treatment session, within four hours of PDT, within 24 hours of PDT, and ninety days after PDT.  
   
   
       14 . The method of  claim 12  wherein said PDT is administered at a time selected from the group consisting of within a single treatment session, within four hours of laser therapy, within 24 hours of laser therapy, and ninety days after threshold laser coagulation therapy.  
   
   
       15 . The method of  claim 12  further comprising treating the patient having undergone PDT to decrease photosensitivity.  
   
   
       16 . The method of  claim 15  wherein the patient is treated with plasmaphoresis.  
   
   
       17 . The method of  claim 12  effecting scar formation in the area treated sufficient to dry the area thereby reducing a need for subsequent PDT treatments.  
   
   
       18 . A method to treat an eye of a patient having undergone laser coagulation therapy for AMD comprising providing to said patient photodynamic therapy (PDT) simultaneously or concomitantly with scatter threshold laser coagulation therapy.  
   
   
       19 . The method of  claim 18  wherein said threshold laser coagulation therapy is administered at a time selected from the group consisting of within a single treatment session, within four hours of PDT, within 24 hours of PDT, and ninety days after PDT.  
   
   
       20 . The method of  claim 18  wherein said PDT is administered at a time selected from the group consisting of within a single treatment session, within four hours of threshold laser coagulation therapy, within 24 hours of threshold laser photocoagulation therapy, and ninety days after threshold laser photocoagulation therapy.  
   
   
       21 . The method of  claim 18  further comprising treating the patient having undergone PDT to decrease photosensitivity.  
   
   
       22 . The method of  claim 21  wherein the patient is treated with plasmaphoresis.  
   
   
       23 . The method of  claim 18  effecting scar formation in the area treated sufficient to dry the area thereby reducing a need for subsequent PDT treatments.  
   
   
       24 . A method to treat a patient having or at risk for developing macular degeneration in an eye comprising treating said eye with photodynamic therapy and scatter threshold laser coagulation therapy within an interval of ninety days.  
   
   
       25 . A method to minimize photosensitivity of a patient receiving a photosensitive agent in combination with laser coagulation therapy to treat or prevent macular degeneration comprising 
 providing an effective amount of the photosensitive agent to at least one vessel of the patient and thereafter activating the agent with a low energy light, and    thereafter treating the patient to reduce the photosensitivity of the agent in the patient.    
   
   
       26 . The method of  claim 25  wherein the patient is treated by plasmaphoresis.  
   
   
       27 . The method of  claim 26  wherein the patient is treated by plasmaphoresis within 24 hours of activating said agent.  
   
   
       28 . The method of  claim 25  wherein the patient is treated with an antidote for the agent.  
   
   
       29 . The method of  claim 25  wherein the patient is treated by separating the plasma of the patient containing the photosensitizing agent from the blood cells of the patient, exposing the separated plasma to light of a wavelength sufficient to activate and thereby reduce the activity of the agent in the plasma, and thereafter returning the blood cells and exposed plasma to the patient.