Purchase this article with an account.
E.M. Frates, L. Migliavacca, M. Di Napoli, N. Orzalesi; The Efficacy of Photodynamic Therapy in the Treatment of Juxtafoveal or Extrafoveal Choroideal Neovascularization . Invest. Ophthalmol. Vis. Sci. 2003;44(13):4894.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
Purpose: To assess the safety and the efficacy of PDT in juxtafoveal and extrafoveal CNV in AMD, in pathologic myopia and other disorders and to evaluate the growth and the activity of the treated CNV. Methods: 46 eyes of 40 patients (26 females, 20 males), aged from 35 to 86 (mean 66), with juxtafoveal (40 eyes, 87%) and extrafoveal (6 eyes, 13%) CNV, underwent PDT treatment. Follow up ranged from 6 to 34 months (mean 14). At baseline and follow up visits patients underwent a complete examination, including ETDRS VA and dynamic ICG-FA angiography (Heildelberg Retinal Angiograph, Heildelberg Eng. Ottobrunn; Germany). The neovascular net diameter was measured with the HRA software. Results: Treated eyes included: AMD 24 eyes (52%):14 (58%) with classic/predominantly classic CNV and 10 (42%) minimally classic/occult; pathologic myopia 11 eyes (23%); RAP 5 eyes (11%); Polypoidal Choroidal Vasculopathy (PCV) 4 eyes (8%); traumatic choroidal rupture 1 eye (2%); Serpiginous Choroiditis 1 eye (2%). At baseline VA ranged from 20/20 to 20/200 (mean 20/45); diameter of the CNV ranged from 300µm to 5560µm (mean 1760µm). Mean of PDT treatments was 2.26 (min 1, max 7). On last visit VA ranged from 20/20 to 20/400 (mean 20/52) and CNV size from 280 µm to 6800 µm (mean 2027µm). 25 eyes (54%) experienced a stabilization or an improvement in VA, 23 (50%) a decreased CNV diameter and 34 (74%) a decreased leakage. 12 eyes (26%) developed subfoveal involvement. In AMD classic/predominantly classic CNV, 7 of 14 eyes (50%) showed a stable or improved VA; lesion size was decreased in 5 (36%) and decreased or no leakage was present in 9 (64%). In AMD minimally classic/occult CNV, 5 of 10 eyes (50%) showed a stable or improved VA; lesion was reduced in 4 (40%) and leakage was decreased in 5 (50%). In pathologic myopia, 8 of 11 eyes (73%) showed a stable or improved VA; lesion was reduced in 6 (55%) and leakage was absent in 10 (91%). In RAP, 3 of 5 eyes (60%) showed stable or improved VA; lesion was reduced in 4 (80%) and leakage was absent in 4 (80%). In PCV, 3 of 4 eyes (75%) showed a stable or improved VA; lesion was reduced in 3 (75%) and leakage was decreased in 4 (100%). Both traumatic choroidal rupture and Serpiginous Choroiditis showed a decrease of 1 line in VA and decreased activity of the lesion. Conclusion: Confirming the results of Huang et al (Photodynamic Therapy for Extrafoveal and Juxtafoveal Choroidal Neovascularization, ARVO 2002), photodynamic therapy in juxtafoveal and extrafoveal CNV is associated with partial stabilization and improvement of VA. Decreased lesion size and leakage were particularly evident in myopic CNV, RAP and PCV.
This PDF is available to Subscribers Only