Verteporfin Photodynamic Therapy for Choroidal Neovascularisation in Angioid streaks

Abstract

Abstract: : Purpose:To report the 12 month outcome of verteporfin photodynamic therapy (PDT) in the treatment of choroidal neovascularisation (CNV) secondary to angioid streaks. Methods: Four centre prospective case series. Patients received TAP protocol PDT at baseline with retreatment as necessary at 3, 6 and 9 months with an option of additional visits at 1.5 and 4.5 months. Refraction protocol logMAR visual acuity (VA) was measured using ETDRS charts. Results: 20 eyes of 19 patients were recruited, 15 male (mean age 49) and 5 female (mean age 62). Fourteen out of nineteen twenty patients (74%) had angioid streaks secondary to pseudoxanthoma elasticum. CNV was classic/no occult in all patients at baseline. Fourteen eyes had subfoveal and 6 juxtafoveal CNV. In the subfoveal group, the mean VA at baseline examination was 51 letters (range 34–71) and 54 letters (range 34–85) at 12 months. The 12 month frequency of <8 letters lost was 10 (71%) and <15 letters 12 (86%); mean number of treatments was 3.0. In the juxtafoveal group the mean VA was 60 letters (26–75) at baseline and 55 letters (34–84) at 12 months. The 12 month frequency of < 8 letters lost was 2 (33%) and <15 letters 3 (50%); mean number of treatments was 3.5. CNV progressed to involve the foveal centre in 3 eyes. No adverse events were recorded in either patient group Conclusions: This small series suggests that treatment of CNV secondary to angioid streaks with verteporfin PDT may limit visual loss in the majority of patients through the first 12 months of follow up.

Keywords: choroid: neovascularization • macula/fovea • photodynamic therapy