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N.K. Waheed, T.G. Chu, S. Mukai; Visudyne Photodynamic Therapy in Subfoveal Neovascular Membranes related to Best’s disease and Combined Hamartoma of the Retina and the Retinal Pigment Epithelium. . Invest. Ophthalmol. Vis. Sci. 2004;45(13):3185.
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Purpose:Photodynamic therapy (PDT) using verteporfin has been used to treat subfoveal choroidal neovascular membranes (CNVM) in adults. There is no report of its use in children or on its use in treatment of CNVM in Best’s disease or combined pigment epithelial and retinal hamartoma. This study looks at PDT for subfoveal CNVM in children with these two conditions. Methods:Retrospective case review of two children with subfoveal CNVM. The child with Best's disease was a 10–year–old girl diagnosed at age 5 years who presented with blurry vision OD. She had vitelliform lesions OU and subfoveal subretinal fluid and hemorrhage OD. The examination, fluorescein angiogram (FA) and optical coherence tomography were consistent with Best's disease OU with subfoveal CNVM OD. The child with combined hamartoma was a 12–year–old boy with blurry vision OD. The examination and FA diagnosed the combined hamartoma with extrafoveal CNVM, and the CNVM was treated with focal argon laser photocoagulation. 12 months later he developed a recurrent CNVM involving the fovea. We treated the CNVM using standard PDT techniques with calculation of verteporfin dose based on body surface area. Results:The children tolerated the PDT well and positioned for the 83 second exposure. The eye with Best's disease required a repeat PDT at 3 months for persistence. With 12 months follow–up in each case, there was regression of the CNVM and stabilization of visual acuity in each case. Conclusions:The use of PDT, although approved for use in adults with subfoveal CNVM, has not been reported in children or with Best's disease or combined pigment epithelial and retinal hamartoma. We successfully used PDT to treat two unusal cases of subfoveal CNVM in children.
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