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G.J. Cordahi, P. Labelle, M. Harissi–Dagher; Photodynamic Therapy in a Pediatric Population: Results, Indications, and Complications . Invest. Ophthalmol. Vis. Sci. 2005;46(13):312.
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Purpose: Photodynamic therapy (PDT) has become the gold standard for the treatment of adult choroidal neovascularization (CNV). We report our experience at a university–based retina practice in using PDT for the treatment of CNV in a pediatric population. The different etiologies, demographics, visual acuity (VA), results, and complications are described. Methods: This is a retrospective interventional study. We included all patients aged 18 years or younger who underwent PDT for a CNV, confirmed by fluorescein angiography (FA). Seven eyes of 6 patients were identified. Medical records (demographics, VA, full eye examination, etiologies, and complications), fundus photography, and FA were reviewed. The treatment parameters were calculated using the standard criteria from the adult PDT studies (Visudyne® dose at 6mg/m2, 50j/cm2, 600mW/cm2). Re–treatment decision was based on the presence of active leakage on FA, repeated every 3 months. Results: Patients included 4 females and 2 males, with ages ranging from 7 to 14 years. Median follow–up period was 23 months (range: 8 to 49 months). Patients received 2 PDT on average. Initial mean VA was 20/400 (20/200 – CF). The etiologies included: idiopathic, histoplasmosis, pathologic myopia, choroidal rupture, and 2 patients (3 eyes) had Best’s disease. The VA was stabilized in 2 eyes (histoplasmosis and Best), and improved in the other 5 eyes (20/20 – CF). No vision loss occurred. No side effects or complications due to PDT were encountered. Conclusions: This study suggests that PDT is safe and efficacious in cases of CNV in a pediatric population. It shows promising results (improved or stable VA), with no local or systemic adverse effects observed during our follow–up. FA demonstrated no leakage at the last visit. Risks, benefits, alternatives, and possible complications should be extensively discussed with the patient’s family before initiating the treatment. Our results warrant further studies to investigate the role of PDT in cases of CNV in children.
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