Photodynamic Therapy of Choroidal Neovascularization Using Verteporfin in Pathologic Myopia: Analysis of Visual Outcomes

Abstract

Abstract: : Purpose:To evaluate the visual outcomes of Photodynamic Therapy (PDT) in patients with subfoveal choroidal neovascularization (CNV) in pathologic myopia (PM). Methods:Forty-four patients with subfoveal CNV secondary to PM underwent PDT with verteporfin (Visudyne; Novartis Ophthalmics). The average age was 66.59±15.48 years (range: 29-93 yrs).Twenty-seven were male and seventeen cases were female. ETDRS visual acuity, ophthalmic examinations, color photographs and fluorescein angiography were performed before the first treatment and every three months. The lesion size was measured on fluorescein angiography. At baseline, the mean greatest linear dimension of the entire lesion was 1315.1±809.1 micron (range: 400-5063 micron). Patients were retreated if they had experienced visual deterioration and if angiographic examination demonstrated an active leaking CNV. Results:Mean best- corrected initial visual acuity was 0.23±0.18(range: 0.05-0.76).Follow-up ranged from 9 months to 12 months and 31 of the 44 patients completed the month 9 examination. At the month 9 examination, mean visual acuity was 0.25±0.23 and 8 (25,8%) of the 31 patients lost fewer than eight letters and 13 (41,9%) improved at least five letters (> 1 line ETDRS). Twenty-five of the 44 patients completed the month 12 examination and here final visual acuity remained stable (average:0.27±0.26); seventeen (68%) of 25 patients decreased fewer than eight letters and 10 (40%) improved at least five letters.These patients received a mean of 1.8 treatment. Four of 44 patients had experience a visual loss > 3 ETDRS lines ( >15 letters), during the follow-up period . treatment. Conclusions:Our work confirms that PDT decreases the loss of vision in patients with CNV secondary to PM, as previously partially demonstrated by the Verteporfin in Photodynamic Therapy (VIP) Study. Our conclusions however must be confirmed with longer follow-up and further prospective studies.

Keywords: myopia • choroid: neovascularization • photodynamic therapy