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S Shaikh, A Ruby, G Williams; Photodynamic Therapy Using Verteporfin for Choroidal Neovascularization in Angioid Streaks . Invest. Ophthalmol. Vis. Sci. 2002;43(13):571.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: To evaluate the efficacy of photodynamic therapy with Verteporfin in the management of choroidal neovascularization (CNV) associated with angioid streaks Methods: Eleven eyes of 9 patients with subfoveal or juxtafoveal CNV due to angioid streaks underwent visual acuity testing, ophthalmic examination, color photography, and fluorescein angiography to evaluate the results of photodynamic therapy with verteporfin. The treatment area for two eyes with juxtafoveal CNV was felt to have included the foveal center and hence conventional laser was not recommended. Retreatment of persistent CNV was based on the criteria from the TAP study. Follow-up ranged from 4 to 18 months. Results: Nine of 11 eyes had subfoveal lesions while 2 eyes had juxtafoveal lesions on initial examination. Fibrous transformation of the CNVM was seen in 9 eyes. Enlargement of the CNV was seen in 7 of these eyes by fluorescein angiography at final follow-up. Initial visual acuity ranged from 20/25 to CF (mean 20/400). Final visual acuity ranged from 20/20 to CF (mean 20/400). Seven eyes with subfoveal CNVM had initial visual acuity of at least 20/200 while only four eyes maintained this level or better after treatment. Following PDT, in one eye with a juxtafoveal CNVM, vision decreased from 20/25 to 20/400 with enlargement and fibrosis of the CNVM and subfoveal extension. In the fellow eye a juxtafoveal CNVM was initially treated and then retreated at 6 weeks. Vision improved to 20/20 and has remained stable five months after the initial treatment. Conclusions: Treatment of CNV secondary to angioid streaks with Verteporfin therapy may have limited potential to significantly alter the poor prognosis of the disease. Nonetheless, aggressive management of these patients with biomicroscopic and fluorescein angiographic examination and timely photodynamic therapy with early retreatment when indicated may decrease the rate of visual loss in these eyes.
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