Photodynamic therapy with verteporfin for juxtafoveal choroidal neovascularization in pathologic myopia: a long-term follow-up study

Am J Ophthalmol. 2007 Mar;143(3):449-54. doi: 10.1016/j.ajo.2006.11.037. Epub 2006 Dec 22.

Abstract

Purpose: To assess the effect of verteporfin photodynamic therapy (PDT) in juxtafoveal choroidal neovascularization (CNV) secondary to pathologic myopia (PM).

Design: Prospective, open-label, consecutive, interventional case series.

Methods: We prospectively followed a series of 48 consecutive patients (49 eyes) with pathologic myopia (> or = 6 diopters) who received verteporfin PDT for juxtafoveal CNV. This population was divided into two groups based on age (group A < or = 55 years old, group B >55 years old), in three subgroups based on CNV lesion size, and in three categories based on refractive error at baseline.

Results: The median follow-up was 32 months (range, 12 to 56 months). Visual acuity (VA) improved by 1 or more Snellen lines in 18 eyes (37%), decreased in 12 eyes (24%), and remained stable in 19 eyes (39%). The median number of lines gained was 2.15, while the median number of lines lost was 2.4. The final mean VA in group A (mean age, 43.9 years) was 20/50 (logMAR 0.41, standard deviation [SD] 0.3) and significantly better (P = .01) than the 20/105 (logMAR 0.72, SD 0.5) in group B (mean age, 67.8 years). Neither CNV size nor refractive error magnitude influenced visual outcomes.

Conclusion: Verteporfin PDT is a promising treatment modality resulting in stable or improved vision in 76% of the myopic eyes with juxtafoveal CNV. Younger patients appear to respond more favorably to treatment.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Choroidal Neovascularization / drug therapy*
  • Choroidal Neovascularization / etiology
  • Female
  • Fluorescein Angiography
  • Follow-Up Studies
  • Fovea Centralis
  • Humans
  • Male
  • Middle Aged
  • Myopia, Degenerative / complications*
  • Photochemotherapy*
  • Photosensitizing Agents / therapeutic use*
  • Porphyrins / therapeutic use*
  • Prognosis
  • Prospective Studies
  • Verteporfin
  • Visual Acuity

Substances

  • Photosensitizing Agents
  • Porphyrins
  • Verteporfin