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U. Introini, M. Setaccioli, A. Ramoni, F. Scotti, S. Donati, R. Brancato; Treatment of Extra–Foveal Choroidal Neovascularization in Pathological Myopia With Photodynamic Therapy – Two Year Results . Invest. Ophthalmol. Vis. Sci. 2005;46(13):342.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: To report the effects of Photodynamic therapy using Verteporfin in the treatment of extrafoveal choroidal neovascularization (CNV) caused by pathologic myopia and to assess its safety and its capability to maintain the CNV outside the foveal avascular zone (FAZ). Methods: Prospective non–comparative interventional case series. 24 eyes of 24 patients (male 13, female 11, mean age 56.37+/–16 yrs) with extra–foveal CNV secondary to pathologic myopia who underwent PDT were followed for 24 months. The patients were divided into two sub–groups according to the age: 8 under 50 yrs, 16 over 50 yrs. Complete ophthalmologic examination, including ETDRS–VA, and fluorescein angiography were performed at baseline and every three months at each follow–up visit. PDT retreatment was performed if evidence of CNV leakage was found on fluorescein angiography. Results: Patients underwent a mean of 2.91 treatments (1.75 in patients <50 yrs, 3.5 in patients >50 yrs), 2.25 in the first year (1.62 <50 yrs, 2.56 >50 yrs), 0.66 in the second year (0.12 <50 yrs, 0.93 >50 yrs). The Visual Acuity at baseline ranged from 20/125 to 20/25 (20/125–20/25 <50 yrs, 20/80–20/25 >50 yrs). At the 24 month follow–up visit, in patients under 50 yrs (8 eyes), 6 eyes (75%) were stable (within ±1 line), 2 eyes (25%) had a severe visual loss (3 or more lines decrease). In patients over 50 yrs (16 eyes), 6 eyes (37.5%) were stable, 1 eye (6.3%) had a mild visual decrease (1,5 line decrease) and 9 eyes (56.2%) had a severe visual loss (3 or more lines decrease). At the 24 month visit, the FAZ was involved by the CNV in 3 (37.5%) out of 8 eyes in patients under 50 yrs. In the group over 50 yrs, at 24 month visit the FAZ was involved by the CNV in 12 eyes (75%) out of the 16 eyes. At the 2 year follow–up visit, no eye of both groups gained any line of visual acuity from baseline. Conclusions:when patients age is less than 50 yrs, our data show that PDT treatment of extrafoveal CNV in pathologic myopia achieves to long–term good visual and anatomic outcome. On the contrary, when the age is over 50 yrs, PDT scarcely influences either the progression of the CNV toward the FAZ, or the severe VA decrease.
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