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M. Harissi–Dagher, M. Sebag, D. Gauthier, G. Marcil, J.–D. Arbour; Photodynamic Therapy of Choroidal Neovascularisation Secondary to Traumatic Choroidal Rupture in Young Patients . Invest. Ophthalmol. Vis. Sci. 2004;45(13):3150.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: Choroidal neovascularisation (CNV) is a rare but significant cause of visual loss complicating ocular injury. This study assesses the safety and efficacy of photodynamic therapy (PDT) with verteporfin in young patients with CNV secondary to traumatic choroidal rupture. Visual acuity (VA), activity of treated CNV, and PDT complications are investigated. Methods: This retrospective review comprises 25 eyes with traumatic choroidal rupture followed since 1984 at the retina service of a university–based hospital. All eyes diagnosed with CNV and treated with PDT are included. Medical records including VA, comprehensive eye examination, color photos and intravenous fluorescein angiography (IVFA) are studied. Visudyne dose is based on body surface area (6 mg/m2), activated with a laser light at 689 nm, at a fluence of 50 J/cm2 and an irradiance of 600 mW/cm2 over a period of 83 seconds. Re–treatments are considered every 3 months based on IVFA findings of CNV leakage. Results: Of the 25 eyes that sustained choroidal rupture, 6 eyes (six patients) developed CNV. Two eyes were treated by conventional laser photocoagulation and dated back to the era before PDT. Four eyes received PDT. Three males and one female were affected with a mean age at presentation of 19 years (range 15 to 26 years). Mean follow–up was 24 months (range 16 to 30 months). Patients received on average 2 PDT treatments. Initial VA ranged from 20/50 to 20/200 (mean 20/100). At the last follow–up, VA ranged from 20/50 to 20/400 (mean 20/100). Two patients had improved VA, one remained stable, and only one experienced visual loss. The greatest linear dimension of the CNV at baseline ranged from 2.64 to 4.36 mm (mean 3.35 mm) and at final evaluation 1.6 to 3.36 mm (mean 2.38 mm). Final IVFA showed absence of leakage in 3 eyes and decreased leakage in the eye with least VA. There were no treatment related side effects. Conclusion: Our study suggests that in these young patients PDT was safe and effective in the treatment of CNV secondary to choroidal rupture. PDT showed encouraging results in stabilizing and improving visual acuity. Stabilization of CNV was correlated with decreased or absent leakage on IVFA. No ocular or systemic complications were encountered in our young patients. Ideally, a randomized controlled trial is desirable to further substantiate the benefits of this therapy. It may, however, be difficult because of the rarity of this entity.
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