Photodynamic Therapy for Choroidal Neovascularization in Angioid Streaks

Abstract

Abstract: : Purpose: To evaluate the outcome of photodynamic therapy (PTD) in the management of choroidal neovascularization (CNV) in angioid streaks (AS). Methods: Fourteen eyes of 11 patients (5 males and 6 females) with actively leaking CNV due to angioid streaks were included. Postphotodynamic therapy assessment was performed after 45 days with retreatment in case of persistant CNV. Results: Mean age was 44 years (33 - 56 y). Ten eyes had subfoveal lesion, and 4 had juxtafoveal lesion on initial examination. Two patients presented bilateral subfoveal CNV. Follow-up ranged from 8 to 20 months. In one case, the fellow eye developed subfoveal CNV during evolution. Three eyes got improved vision, 7 eyes got stable vision and 4 had decreased vision.Cessation of fluorescein leakage from CNV was achieved in 4 eyes. Enlargement of the CNV was seen in 3 eyes. Two patents had 1 year of good outcome with improving of the vision (20/25, 20/60).Then they relapsed: visual acuity decreased to CF. All patients had been treated at least twice (2 to 4) Conclusions: CNV with angioid streaks lead to legal blindness in half of eyes within 1 year. PDT for subfoveal CNV due to AS with closer examination (30 - 45 days) and early retreatment may decrease the rate of visual loss in these eyes. Nonetheless, the long term prognosis of this disease remains poor in 35 % of cases.

Keywords: photodynamic therapy • choroid: neovascularization • retina