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MT Tennant, M Shuler, A Martidis, JB Belmont, WE Benson; Photodynamic Therapy (PDT) in Multifocal Choroiditis (MFC) . Invest. Ophthalmol. Vis. Sci. 2002;43(13):595.
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Purpose: To describe the treatment of MFC-associated choroidal neovascularization (CNV) with PDT Methods: Single case report of a patient with MFC and sequential bilateral peripapillary CNV treated with subtenons and intravitreal triamcinolone (IVT), followed by PDT for juxtafoveal CNV with 1 year follow-up. Results: A 35 year old, healthy male presented with poor vision in the left eye due to large peripapillary CNV that had extended into the subfoveal space (visual acuity 20/400 OD, 20/20 OS). Subtenons triamcinolone injection(1mg) was performed but vision continued to deteriorate to counting fingers in the left eye. IVT OS (4mg) resulted in resolution of CNV leakage and improvement in vision (visual acuity 20/200). On follow-up, an initially small peripapillary CNV in the right eye showed active growth toward the fovea despite IVT (4mg) and underwent PDT for juxtapapillary CNV (visual acuity 20/40). Six weeks later the patient’s symptoms had resolved with no active leakage on Fluorescein Angiography (visual acuity 20/25). One month later, the patient noted loss of visual field with metamorphopsia of the right eye. Repeat Fluorescein Angiography demonstrated reactivation of the juxtafoveal CNV with symptomatic visual field loss (visual acuity 20/20)(Figure 1). Repeat PDT was performed two weeks later to the CNV Complex. Follow up one month later demonstrated symptomatic improvement and no leakage. The patient was followed on a monthly basis for another two months with maintenance of 20/20 vision in the right eye and stable 20/400 vision in the left eye. Conclusion: We report the use of PDT in treating MFC-associated CNV with stabilization of vision and clinical exam. Figure 1. Color photograph of CNV complex prior to second PDT Treatment (Visual acuity 20/20) View OriginalDownload SlideView OriginalDownload Slide
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