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S.M. Szabo, U. Schmidt–Erfurth, D. Sarraf, R. Michels, M.J. Potter; Clinical Outcomes Following Treatment of Subretinal Neovascularization in Idiopathic Juxtafoveolar Retinal Telangiectasis using Photodynamic Therapy with Verteporfin (Visudyne) . Invest. Ophthalmol. Vis. Sci. 2004;45(13):3182.
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Purpose: To report the clinical course and outcome of patients treated with photodynamic therapy (PDT) with verteporfin (Visudyne, Novartis Opthalmics, Atlanta, GA) for subretinal neovascular membranes (SRNVM) secondary to Type 2A idiopathic juxtafoveolar telangiectasis (IJT). Methods: We report a retrospective, noncomparative interventional case series. Eight eyes of 7 patients with subfoveal or juxtafoveal SRNVMs secondary to IJT were treated with PDT with verteporfin. Ophthalmic examination, fluorescein angiography, and visual acuity testing were performed prior to treatment. Patients returned every 3 months for consideration of re–treatment. Re–treatment was performed primarily on the basis of the presence of leakage on fluorescein angiography, but visual acuity, the presence of blood, subretinal fluid, and fibrosis were also taken into account. Results: Four patients were female (57%), 3 were male (43%), and the mean age was 53.6 years. Baseline Snellen visual acuity ranged from 20/40 to 20/400 (median 20/100+2). Mean baseline logMAR acuity was 0.815 (approximate Snellen equivalent, 20/125), and 5/8 eyes (62.5%) had an initial acuity of 20/200 or better. Mean follow–up time was 16.9 months (range, 2 to 34 months). Patients received a mean of 2.25 (range, 1–4) treatments. Snellen visual acuity improved in four eyes (>1 line improvement; 50%), stayed the same in two eyes (+1 line; 25%) and decreased in two eyes (>1 line decrease; 25%) by the end of treatment. Median visual acuity at the end of follow up was 20/80. Mean final logMAR acuity was 0.8, or Snellen equivalent of 20/125. Five of 8 eyes (62.5%) ended with an acuity of 20/200 or better. No further leakage from an active SRNVM was seen in any of the 8 eyes following cessation of treatment. Conclusions: Previously reported outcomes for SRNVM in type 2A IJT, with respect to both natural history and treatment with argon laser or surgery, have been uniformly poor. PDT may be considered for these patients due to its excellent safety profile and clinically favorable outcomes in this study.
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