Verteporfin Photodynamic Therapy for non–AMD Causes of Subfoveal Choroidal Neovascularization.

Abstract

Abstract: : Purpose:To investigate the efficacy of verteporfin photodynamic therapy (PDT) in patients with subfoveal choroidal neovascularization (CNV) due to causes other than those studied in TAP and VIP. Methods:Patients attending a regional medical retina service with predominantly classic CNV were recruited into a prospective cohort study. Eyes with age–related macular degeneration (AMD) or pathological myopia (PM) were excluded. Patients received TAP protocol PDT at baseline with retreatment as necessary at 3 monthly intervals with an option of additional visits at 1.5 and 4.5 months. Refraction protocol logMAR visual acuity (VA) was measured using ETDRS charts and recorded as number of letters read at 1 metre. Primary outcome variable was the proportion of eyes with < 15 letters loss from baseline. Results:42 eyes of 41 patients were recruited; 11 PIC/POHS, 10 angioid streaks, 2 posterior uveitis (1 focal choroiditis, 1 birdshot), 2 toxoplasmosis, 1 central serous retinopathy (CSR), 1 Stargardt’s disease and 15 idiopathic. Mean duration of follow–up was 14.7 months (range 3–36). No adverse events were observed. 30 (71%) of the 42 eyes lost < 15 letters from baseline. Outcome by disease group is shown in the Table. 

*Excludes patients with less than 9 months follow–up Conclusions:The response to PDT therapy of CNV in diseases other than AMD or PM is variable with efficacy appearing to be better in PIC/POHS, toxoplasmosis, posterior uveitis and idiopathic CNV and worse in angioid streaks. Overall response appears similar to that seen in AMD as reported by TAP.

Keywords: photodynamic therapy • choroid: neovascularization