SCIENTIFIC REPORT

Photodynamic treatment versus photodynamic treatment associated with systemic steroids for idiopathic choroidal neovascularisation

Alfonso Giovannini, Piergiorgio Neri, Lucia Mercanti and Claudia Bruè

Neuroscience Department—Ophthalmology Section, Polytechnic University of Marche, Ancona, Italy

Correspondence to:
Correspondence to:
Dr P Neri
Clinica Oculistica, Azienda Ospedaliera Universitaria, Ospedali Riuniti di Ancona, Via Conca 71, 60100 Torrette-Ancona, Italy; doctor_blacks{at}hotmail.com

Aim: To compare photodynamic therapy (PDT) with PDT associated with systemic steroids (SS) for the control of juxta/subfoveal idiopathic choroidal neovascularisation (ICNV).

Methods: Patients with juxta/subfoveal ICNV were randomised and then treated. Visual gain and loss were defined as improvement in or worsening for two or more lines of best-corrected visual acuity (BCVA), respectively. Choroidal neovascularisation size after treatment was classified as "increased" and "reduced" if it was increased or reduced by >200 µm², respectively.

Results: 10 patients were treated with PDT, 10 with SS followed by PDT. The median follow-up time was 22 and 21 months for the "steroid+PDT group" and the "PDT group", respectively. At 1 year, in the PDT group, five patients had stable/improved BCVA, and five became worse; the mean number of PDT was 2.3; in the steroid+PDT group, all patients were stable/improved and the mean number of PDT was 1.2. The difference between the two groups was significant (p<0.05). At 1 year, the ICNV size after treatment was better in the steroid+PDT group than in the PDT group (p<0.05).

Conclusion: The use of SS before PDT has shown better BCVA outcome than PDT alone (p<0.05), reducing the mean number of PDT applications (1.2 vs 2.3, respectively), with smaller scar size.

Abbreviations: BCVA, best-corrected visual acuity; CNV, choroidal neovascularisation; FA, fluorescein angiography; ICNV, idiopathic choroidal neovascularisation; PDT, photodynamic therapy; SS, systemic steroids

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