Photodynamic therapy for juxtafoveal choroidal neovascularization in myopic eyes

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Abstract

Purpose

To report the results of photodynamic therapy in myopic patients with juxtafoveal choroidal neovascularization (CNV).

Design

Interventional case series.

Methods

Three consecutive myopic patients with juxtafoveal CNV were treated by photodynamic therapy with the same protocol as the one used to treat subfoveal CNV. Visual acuity was measured on Early Treatment Diabetic Retinopathy Study (ETDRS) charts by an independent observer. Fluorescein angiography was performed 6 and 12 weeks after photodynamic therapy and then every 12 weeks.

Results

In all three patients, one treatment of photodynamic therapy using verteporfin resulted in the involution of the CNV and improvement in best-corrected visual acuity from 20/50 or 20/40 to 20/25 or more. No retreatment was required during follow-up, which lasted for 12 to 24 months (mean = 17 months).

Conclusion

Photodynamic therapy may be an effective treatment for juxtafoveal CNV in myopic eyes.

Section snippets

Case 1:

In July 2000, a 42 year-old woman was successfully treated by photocoagulation for extrafoveal CNV in her left eye. Three months after this treatment, best-corrected visual acuity was 20/20, with a correction of –17.0 diopters (D). In October 2000, the patient complained of recurrences of metamorphopsia and visual loss. Visual acuity was 20/40, with an Early Treatment Diabetic Retinopathy Study (ETDRS) score of 73. Fluorescein angiography showed juxtafoveal recurrence of the CNV. Photodynamic

Case 2:

A 58-year-old woman complained of metamorphopsia and visual loss in her right eye. Best-corrected visual acuity was 20/40, with an ETDRS score of 71 (the spherical equivalent of –10.50 D). Fluorescein angiography showed juxtafoveal CNV. Photodynamic therapy was applied using verteporfin, according to the standard protocol used in the VIP study.1 Fluorescein angiography was performed 6 and 12 weeks after PDT and then every 12 weeks to detect any residual fluorescein leakage suggesting the need

Case 3:

A 49-year-old woman complained of metamorphopsia and visual loss in her right eye. Visual acuity was 20/50, with an ETDRS score of 67 (the spherical equivalent of –8 D). Fluorescein angiography showed juxtafoveal CNV. Photodynamic therapy was applied using verteporfin, according to the standard protocol used in the VIP study.1 Fluorescein angiography was performed 6 and 12 weeks after PDT and then every 12 weeks to detect any residual fluorescein leakage suggesting the need for additional

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    2008, American Journal of Ophthalmology
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    We have reported that 18.5% of the eyes with a myopic CNV were nonsubfoveal.2 The results of earlier studies have shown a favorable visual outcome of PDT for nonsubfoveal myopic CNV treated by PDT.12,13,30,31 Lam and associates prospectively examined 11 eyes from 11 patients with juxtafoveal CNV secondary to pathologic myopia, and the results showed that the BCVA improved significantly from 0.57 to 0.39 logMAR units at the one year follow-up.31

  • Photodynamic Therapy With Verteporfin for Juxtafoveal Choroidal Neovascularization in Pathologic Myopia: A Long-term Follow-up Study

    2007, American Journal of Ophthalmology
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    A small case series has also investigated the effect of verteporfin PDT in the treatment of juxtafoveal myopic CNV. Recently, Cohen and associates18 reported the benefit of verteporfin treatment on three cases. Lam and associates19 performed a small, prospective, noncomparative trial of 11 eyes with juxtafoveal CNV and found a good response to verteporfin therapy after one year of follow-up.

  • Photodynamic Therapy for Nonsubfoveal Choroidal Neovascularization in 100 Eyes With Pathologic Myopia

    2007, American Journal of Ophthalmology
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    To the best of our knowledge, our study is the largest case series on the outcome of PDT in nonsubfoveal myopic CNV. Cohen and associates23 found an improvement towards near-normal visual acuity in three eyes with juxtafoveal CNV and baseline visual acuity of 20/50 to 20/40 after 12 to 24 months. Gelisken and associates24 followed three eyes with extrafoveal CNV for 36 months on average and found an improvement of 1 to 2 lines and the disappearance of leakage.

  • Photodynamic therapy for juxtafoveal choroidal neovascularization associated with multifocal choroiditis

    2006, American Journal of Ophthalmology
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    In particular, in the TAP Investigation 17 eyes with juxtafoveal CNV were treated, obtaining encouraging results.17 Other authors have also described positive results regarding the effect of PDT for juxtafoveal CNV secondary to various inflammatory conditions,16 angioid streaks,18,19 and degenerative myopia.20 The present study has important limitations, especially regarding the small number of patients and the absence of a control group.

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