Photodynamic therapy of idiopathic and inflammatory choroidal neovascularization in young adults☆
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
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Manuscript no. 220207.
The authors have no financial interest in any of the products mentioned in this article.