Photodyanamic Therapy for Post-Choroiditis Choroidal Neovascularization

Abstract

Abstract: : Purpose: The TAP investigation has shown that photodyanamic therapy (PDT) with verteporfin safely reduces the risk of moderate vision loss (=>15 letters) in patients with predominantly classic choroidal neovascularization (CNV) secondary to AMD. Visual outcome of choroidal neovascularization in patients with posterior choroiditis has not been widely documented. We report visual outcome of PDT in patients with CNV due to punctate inner choroidopathy, multifocal inner choroidopathy, multifocal chorioditis, Vogt Kanayagi Harada syndrome and toxoplasmic chorioretinitis. Methods: We prospectively reviewed the charts of 12 patients who underwent PDT for CNV secondary to posterior choroiditis. Two patients were excluded since they defaulted on follow up. Results: Mean age at presentation was 35.5 years and the mean follow up of 15.5 months. In these patients the mean presenting visual acuity was 31.9 LogMar letters and the mean final vision was 33.0 LogMar letters. Our patients did not have any significant complications to the verteporfin dye. Ninety percentage of our patients avoided visual loss of => 8 and 15 letters of LogMar chart and no one had a severe visual loss of => 30 LogMar letters. In our series of patients, Visual acuity worsened in 40% of the patient was unchanged in 30% and had improved in 30%. Conclusion:Prior to the advent of photodyanamic therapy, subfoveal CNVs if treated with argon laser photocoagulation, sustained sudden drastic drop in the vision. According to the MPS study results, this vision was however, found to be better than if the CNV was left untreated. Photodyanamic therapy for choroidal neovascularization for post- choroiditis CNV has shown encouraging results. Whether visual benefit will be sustained for longer period needs to be studied. To further substantiate benefits of this therapy, longer follow up, larger series of patients with wider indications, need to be analyzed.

Keywords: choroid: neovascularization • photodynamic therapy • inflammation