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Combined photodynamic therapy and intravitreal triamcinolone injection for the treatment of choroidal neovascularisation secondary to pathological myopia: a pilot study
  1. Javier A Montero,
  2. Jose M Ruiz-Moreno
  1. VISSUM Alicante Institute of Ophthalmology, Retina Unit, Alicante, Spain
  1. Correspondence to: Dr J A Montero VISSUM Alicante Institute of Ophthalmology, Retina Unit, Avenida de Denia s/n, 03015 Alicante, Spain; javmonmor{at}hotmail.com

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Intravitreous triamcinolone associated with PDT should preferably be used among elderly patients who usually show lower visual acuity and a poorer response to PDT, or among patients with recurrent or greater CNVs

High myopia is a major cause of legal blindness in many developed countries, affecting 2% of the general population. Myopic maculopathy, mainly in the form of subfoveal choroidal neovascularisation (CNV), is the most common cause of vision loss in patients with high myopia. The appearance of lacquer cracks and the presence of high levels of vascular endothelial growth factor and pigment epithelium-derived factor1 are probably involved in the development of myopic CNV. These findings have given way to new theories and approaches to the treatment of myopic CNV.

Different therapeutic approaches have been tried for this condition. Photocoagulation2 and surgical removal of subfoveal or juxtafoveal myopic CNV3 are no longer performed because of poor final visual acuity. During the past few years, the two main approaches to subfoveal myopic CNV have been macular translocation4 and photodynamic therapy (PDT). PDT has been a major advance in the management of this condition after the good results achieved by the Verteporfin in Photodynamic 1 Study.5,6 The response of myopic CNV to PDT is considerably better than that of age-related macular degeneration (AMD), requiring less PDT sessions and resulting in better final visual acuity.7 This is probably related to the aetiopathogenic mechanism of myopic CNV, …

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