Elsevier

Ophthalmology

Volume 110, Issue 7, July 2003, Pages 1315-1320
Ophthalmology

Photodynamic therapy of idiopathic and inflammatory choroidal neovascularization in young adults

https://doi.org/10.1016/S0161-6420(03)00466-4Get rights and content

Abstract

Purpose

To evaluate the treatment of subfoveal choroidal neovascularization (CNV) using photodynamic therapy (PDT) with verteporfin (Visudyne; Novartis, Duluth, GA) in young adults.

Design

Retrospective noncomparative interventional case series.

Participants

Nineteen eyes of 17 patients with classic, subfoveal CNV treated with PDT using verteporfin, excluding eyes with CNV secondary to age-related macular degeneration, angioid streaks, and myopia.

Main outcome measures

Snellen visual acuity before and after PDT.

Results

Nineteen eyes were followed an average of 12.8 months (range, 4–33 months) after PDT. Before treatment, visual acuity measured ≥20/40 in 0 eyes (0.0%), <20/40 to >20/200 in 11 eyes (57.9%), and ≤20/200 in 8 eyes (42.1%). After treatment, visual acuity measured ≥20/40 in four eyes (21.1%), <20/40 to >20/200 in eight eyes (42.1%), and ≤20/200 in seven eyes (36.8%). Six eyes (31.6%) underwent retreatment, with only two eyes retreated twice. Four eyes underwent eventual surgical removal of the CNV after PDT.

Conclusions

Photodynamic therapy seems to be useful in stabilizing and improving visual acuity in young adults with subfoveal CNV secondary to idiopathic and inflammatory etiologies.

Section snippets

Material and methods

The charts of patients undergoing PDT between November 1999 and January 2002 at the New England Eye Center, Boston, Massachusetts, were identified from a PDT log and reviewed. Eyes treated for subfoveal CNV secondary to AMD, angioid streaks, or myopia were excluded. A total of 19 eyes of 17 patients with actively leaking subfoveal CNV secondary to idiopathic or inflammatory etiologies were identified from the chart review and included in the study. Inflammatory etiologies included punctate

Results

Nineteen eyes of 17 patients consisting of 4 men and 13 women were treated with PDT using verteporfin for subfoveal CNV secondary to idiopathic or inflammatory etiologies (Table 1). Eyes were followed for a mean of 12.8 months (range, 4–33 months) after initial PDT treatment. The age of the patients ranged from 20 to 56 years (mean, 42.0 years). The etiology of the CNV was idiopathic in 10 eyes, PIC in 5 eyes, MFC in 3 eyes, and either MFC or PIC in 1 eye.

Initial treatment of the CNV consisted

Case 1

A 24-year-old female (patient 15) was initially referred in January 1997 for decreased vision in the right eye noted when covering her left eye. Visual acuity measured 20/800 in the right eye and 20/20 in the left eye. Multifocal choroiditis was diagnosed with a subfoveal CNV present on FA. Oral prednisone, 60 mg daily, was prescribed with a slow taper over a 10-month period. Vision gradually improved to 20/50 in November 1997 and 20/25 in 1999. The patient remained stable until noticing a

Discussion

Although the clinical course of subfoveal CNV secondary to AMD is well documented in the literature, sparse information exists on both the natural history (Table 3) and treatment (Table 4) of subfoveal CNV secondary to idiopathic or inflammatory etiologies. Most published studies report low patient numbers with variable visual results. In many of the studies, subfoveal CNV is intermixed with juxtafoveal lesions, creating further confusion on the true course of disease. As a result, no clear

References (16)

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Manuscript no. 220207.

The authors have no financial interest in any of the products mentioned in this article.

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