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Br J Ophthalmol doi:10.1136/bjo.2006.103135

Photodynamic treatment Versus Photodynamic treatment associated with systemic steroids for idiopathic choroidal neovascularization.

  1. Alfonso Giovannini,
  2. Piergiorgio Neri (doctor_blacks{at}hotmail.com),
  3. Lucia Mercanti,
  4. Claudia Bruè
  1. Neuroscience Department-Ophthalmology Section, Italy
  2. Polytechnic University of Marche, Ancona, Italy, Italy
  3. Neuroscience Department-Ophthalmology Section, Italy
  4. Neuroscience Department-Ophthalmology Section, Italy
    • Published Online First 3 January 2007

    Abstract

    Background: To compare photodynamic treatment (PDT) versus PDT associated with systemic steroids (SS) for the control of juxta/sub-foveal idiopathic choroidal neovascularization (ICNV).

    Methods: Patients with juxta/sub-foveal ICNV were randomized and then treated. Visual gain and loss were defined as a getting better or worsening of 2 or more lines of best-corrected visual acuity (BCVA), respectively. CNV size after treatment was classified as "increased" and "reduced" if increased or reduced of more than 200 & [mu]m2, respectively.

    Results: Ten cases were treated with PDT, 10 with SS followed by PDT. The median follow-up time was 22 months and 21 months for "Steroid+ PDT group" and "PDT group", respectively. At one year, in "PDT group", 5 patients had stable/improved BCVA, while 5 got worse; the mean number of PDT was 2.3; in "Steroids+PDT group" all patients were stable/improved and the mean number of PDT was 1.2. The difference between the two groups was statistically significant (p<0.05). At one year, the ICNV size after treatment was better in "Steroid+PDT group" than "PDT group" (p<0.05).

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

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