Abstract
Background
In patients with classic subfoveal choroidal neovascularization (CNV) secondary to pathologic myopia (PM), photodynamic therapy (PDT) has been shown to stabilize the visual acuity. We have analyzed the long-term visual prognosis after PDT in patients with CNV secondary to PM.
Methods
In a retrospective study we reviewed the clinical charts of 102 patients. PDT was performed following the procedures described in the VIP and TAP study protocols. Follow-up examinations and PDT treatment were scheduled in 3-month intervals. Indications for retreatment were an active leaking CNV in combination with visual disturbances or visual loss. To assess treatment effects we analyzed the number of letters read on the ETDRS charts. The primary efficacy outcome was the proportion of eyes that had fewer than eight letters loss or gain at 24 months. Secondary efficacy outcomes included the proportion of eyes that had fewer than 15 letters loss or gain and the proportion of eyes that had fewer than 30 letters loss or gain at month 24.
Results
One hundred and two patients were included into the study. Mean follow-up was 32.5±5.7 months. Patients received an average of 2.2 treatments from study entry through the last follow-up, resulting in a total of 221 PDT sessions throughout the study. At 24 months 46% lost at least eight letters. A loss of at least 15 (30) letters was observed in 25% (8%). Improvement of at least eight letters was noted in 8%. Larger improvements of at least 15 letters occurred only in 4% of study eyes.
Conclusion
Our study suggests that PDT can increase the chance of stabilizing or improving vision compared with the placebo arm of VIP trial.
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References
Avila MP, Weiter JJ, Jalkh AE, Trempe CL, Pruett RC, Schepens CL (1984) Natural history of choroidal neovascularization in degenerative myopia. Ophthalmology 91:1573–1581
Barnes RM, Gee L, Taylor S, Briggs MC, Harding SP (2004) Outcomes in verteporfin photodynamic therapy for choroidal neovascularisation—‘beyond the TAP study’. Eye 18(8):809–813
Cohen SY, Bulik A, Dubois L, Quentel G (2003) Photodynamic therapy for juxtafoveal choroidal neovascularization in myopic eyes. Am J Ophthalmol 136(2):371–374
Cohnen SY, Laroche A, Leguen Y, Soubrane G, Coscas GJ (1996) Etiology of choroidal neovascularization in young patients. Ophthalmology 103:1241–1244
Fardeau C, Soubrane G, Coscas G (1992) Photocoagulation des néovaisseax sousrétiniens compliquant la dégénérescence myopique. Bull Soc Ophtalmol Fr 92:239–242
Hochkiss ML, Fine SL (1981) Pathologic myopia and choroidal neovascularization. Am J Ophthalmol 91:177–183
Jalkh AE, Weiter JJ, Trempe CL, Pruett RC, Schepens CL (1987) Choroidal neovascularization in degenerative myopia: role of laser photocoagulation. Ophthalmic Surg 18(10):721–725
Johnson DA, Yannuzzi LA, Shakin JL, Lightman DA (1998) Lacquer cracks following laser treatment of choroidal neovascularization in pathologic myopia. Retina 18:117–124
Lam DS, Chan WM, Liu DT, Fan DS, Lai WW, Chong KK (2004) Photodynamic therapy with verteporfin for subfoveal choroidal neovascularisation of pathologic myopia in Chinese eyes: a prospective series of 1 and 2 year follow up. Br J Ophthalmol 88(10):1315–1319
Lanzetta P, Battaglia Parodi M, Ambesi-Impiombato M, Ravalico G, Bandello F (2004) Early neovascular bridging after photodynamic therapy of myopic choroidal neovascularization. Graefes Arch Clin Exp Ophthalmol 242(10):840–844
Montero JA, Ruiz-Moreno JM (2003) Verteporfin photodynamic therapy in highly myopic subfoveal choroidal neovascularisation. Br J Ophthalmol 87(2):173–176
Ruiz-Moreno JM, Montero JA (2003) Subretinal fibrosis after photodynamic therapy in subfoveal choroidal neovascularisation in highly myopic eyes. Br J Ophthalmol 87(7):856–859
TAP Study Group (1999) Photodynamic therapy of subfoveoal choroidal veovascularization in age-related macular degeneration with verteporfin. One-year results of 2 randomized clinical trials—TAP report 1. Arch Ophthalmol 117:1329–1345
TAP Study Group (2001) Photodynamic therapy of subfoveal choroidal neovascularization in age-related macular degeneration with verteporfin: two-year results of 2 randomized clinical trials—TAP report 2. Arch Ophthalmol 119(2):198–207
VIP Study Group (2001) Photodynamic therapy of subfoveal choroidal neovascularization in pathologic myopia with verteporfin. 1-year results of a randomized clinical trial—VIP report no. 1. Ophthalmology 108(5):841–852
VIP Study Group (2001) Verteporfin therapy of subfoveal choroidal neovascularization in age-related macular degeneration: two-year results of a randomized clinical trial including lesions with occult with no classic choroidal neovascularization—verteporfin in photodynamic therapy. Report 2 Am J Ophthalmol 131:541–560
VIP Study Group (2003) Verteprofin therapy of subfoveal choroidal neovascularization in pathologic myopia. 2-year results of a randomized clinical trial—VIP Report No. 3 Ophthalmology 110:666–673
VIP-Study Group (2003) Verteprofin therapy of subfoveal choroidal neovascularization in pathologic myopia. 2-year results of a randomized clinical trial—VIP Report No. 3 Ophthalmology 110:666–673
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Schnurrbusch, U.E.K., Jochmann, C., Wiedemann, P. et al. Quantitative assessment of the long-term effect of photodynamic therapy in patients with pathologic myopia. Graefe's Arch Clin Exp Ophthalmol 243, 829–833 (2005). https://doi.org/10.1007/s00417-005-1147-4
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DOI: https://doi.org/10.1007/s00417-005-1147-4