SCIENTIFIC REPORT

Photodynamic therapy for subfoveal choroidal neovascularisation in Vogt-Koyanagi-Harada disease

S R Nowilaty, M Bouhaimed and the Photodynamic Therapy Study Group

Vitreoretinal Division, Department of Ophthalmology, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia

Correspondence to:
Correspondence to:
Sawsan R Nowilaty
MD, Vitreoretinal Division, Department of Ophthalmology, King Khaled Eye Specialist Hospital, PO Box 7191, Riyadh 11462, Saudi Arabia; snowilaty{at}kkesh.med.sa

Aim: To assess the effects of photodynamic therapy (PDT) with verteporfin in the treatment of subfoveal choroidal neovascularisation (CNV) secondary to Vogt-Koyanagi-Harada disease (VKH).

Methods: Six eyes of six patients with VKH who developed subfoveal CNV underwent standard PDT. Repeated treatments were performed at 3 month intervals for persistent leakage. Charts and angiographic data were analysed retrospectively.

Results: Age of patients ranged between 17 years and 27 years. Five CNV lesions were recent and classic (greatest lesion diameter was 1100–3100 µm). One CNV was chronic and partially scarred. Mean visual acuity (VA) at presentation was 20/200. Five patients had more than 1 year of follow up. In five eyes there was active inflammation and CNV. Of these eyes, the first three required one PDT each. The final CNV scar was smaller/stable with improvement of VA in two eyes. The third developed a larger CNV scar with loss of two lines of VA. Submacular fibrosis developed in all three. In the fourth eye, mild CNV leakage persisted after one PDT but hazy media precluded a second PDT. At 18 months the CNV scar and VA were stable. The fifth case, with mild inflammation, required three PDT. The CNV leakage became minimal, the lesion became smaller, and VA improved significantly. The sixth eye with CNV had no inflammation and needed two PDT sessions to halt the CNV leakage. The final lesion was smaller and vision was stable. There were no PDT related complications in our series.

Conclusion: Photodynamic therapy with verteporfin appears to be a safe and viable treatment option for subfoveal CNV secondary to VKH. It offers a chance for stabilisation or even improvement of vision. Further study is warranted.

Abbreviations: CNS, central nervous system; CNV, choroidal neovascularisation; FA, fluorescein angiography; PDT, photodynamic therapy; VA, visual acuity; VKH, Vogt-Koyanagi-Harada disease

Keywords: photodynamic therapy; subfoveal choroidal neovascularisation; Vogt-Koyanagi-Harada disease

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