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K.S. Kim, N.Y. Lee; Photodynamic Therapy With Verteporfin for Drusenoid Pigment Epithelial Detachment: A Case Report . Invest. Ophthalmol. Vis. Sci. 2006;47(13):3253.
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Drusenoid pigment epithelial detachment(PED) was clearly distinguished from the other type of Age–related macular retinal degeneration by its better prognosis. But in some cases, it is irreversibly changed to neovascularization or geographic atrophy. We show a patient with drusenoid PED who treated with photodynamic therapy(PDT) with verteporfin for whom a relatively long follow–up is available.
A 69–year–old male patient visited our clinic because of decreased vision which had developed 3 days previously in his left eye. Best corrected visual acuity was 0.5 in the left eye. On fundus examination, there were multiple drusen around the fovea, irregular elevation of retinal pigment epithelium, choroidal neovascular membrane and PED on the macula. Fluorescein angiogram(FAG) showed stippled hyperfluorescence with indistinct border in the early phase and hyperfluorescence due to the leakage from CNV. PDT with verteporfin was performed. Forty–five days after PDT, visual acuity was 0.6 and on fundus examination, there were stationary drusenoid PED and CNV. Optical coherence tomography(OCT) showed typical hyperreflectivity of the drusenoid material surrounded by coalescent soft drusen. Eight months after PDT, FAG and ICG angiogram showed decresased hyperfluorescence. OCT showed less hyperreflectivity and regression of PED. Fourteen months after PDT, there was no leakage on FAG, it showed regression of CNV and visual acuity was 0.6.
Angiographically, drusenoid PED changed for the better and finally disappeared over a long period of time. Metamorphopsia is resolved completely and visual acuity improved gradually.
Drusenoid PED showed good prognosis in general. But for high risk patient who want to receive preventive treatment, PDT is the only safe alternative.
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