Low Fluence Photodynamic Therapy to Treat Choroidal Neovascularization in Pathological Myopia: Efficacy and Safety

Abstract

Purpose: : To evaluate efficacy and safety of low fluence photodynamic therapy (LFPDT) protocol to treat choroideal neovascularization (CNV) in pathological myopia (PM).

Methods: : Thirty-two eyes with CNV in PM (spherical equivalent >/= -6 diopters) underwent LFPDT, using using treatment parameters reduced to 25mJ/cm2, 300mW/cm2, with standard dose of verteporfin and timing. Best corrected visual acuity (BCVA) was measured using ETDRS charts. Biomicroscopy and fluorescein angiography (FA) were evaluated, with particular attention was paid to the detection of changes (depigmentation/atrophy) at the RPE level in areas exposed to laser light, in comparison with baseline conditions.

Results: : Mean follow-up was 8.78±3.05 months (range: 4-13). After 1.37±0.66 treatments (range:1-3), BCVA was stable (p>0.05). The greatest linear dimension (GLD) did not change significantly (p>0.05) at the end of follow-up. No patient showed signs of RPE depigmentation/ atrophy around the lesion at baseline. At the end of follow-up those signs were present in 6 eyes (18%).

Conclusions: : LFPDT is effective and safe in CNV secondary to PM treatment, stabilizing visual acuity and lesion dimension and determining mild RPE changes. Further controlled study is warranted to demonstrate the long term efficacy and safety of this treatment option.

Keywords: choroid: neovascularization • photodynamic therapy • retinal pigment epithelium