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Photodynamic therapy with verteporfin for choroidal neovascularization in patients with angioid streaks.

Lee JM, Nam WH, Kim HK - Korean J Ophthalmol (2007)

Bottom Line: Standardized protocol refraction, visual acuity testing, ophthalmologic examination, color photographs, fluorescein angiograms and indocyanin angiograms were used to evaluate the results of PDT with verteporfin.Main outcome measures were visual acuity and CNV size.The mean greatest linear dimension (GLD) at baseline was 2400+/-766.81 micrometer, and the mean GLD at the last examination was 3483+/-444.59 micrometer.

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology, Kangnam Sacred Heart Hospital, College of Medicine, Hallym University, Seoul, Korea.

ABSTRACT

Purpose: To evaluate the functional and anatomic outcomes of photodynamic therapy (PDT) for choroidal neovascularization (CNV) in patients with angioid streaks.

Methods: The authors retrospectively evaluated 6 consecutive patients (6 eyes) with CNV secondary to angioid streaks. All patients were treated with standard PDT with verteporfin protocol. Standardized protocol refraction, visual acuity testing, ophthalmologic examination, color photographs, fluorescein angiograms and indocyanin angiograms were used to evaluate the results of PDT with verteporfin. Main outcome measures were visual acuity and CNV size.

Results: Their mean age was 61.3+/-5.50 years (range, 53-68 years). Follow-up time ranged from 12 to 38 months with mean of 20.5+/-10.91 months. The mean visual acuity at baseline was 20/100 (range 20/25-20/500), and the mean visual acuity at the last examination was 20/320(range 20/125-counting finger). The mean greatest linear dimension (GLD) at baseline was 2400+/-766.81 micrometer, and the mean GLD at the last examination was 3483+/-444.59 micrometer.

Conclusions: PDT for CNV associated with angioid streaks seemed to slow down but not prevent the progression of the disease and associated visual loss.

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Related in: MedlinePlus

Case 5 : Pretreatment fundus photography (A) and fluorescein angiogram (B) reveals subfoveal choroidal neovascular membrane associated with hemorrhage. Posttreatment fundus photography (C) and fluorescein angiogram (D) at 9 months reveal marked enlargement, increased leakage, and disciform conversion of the neovascular complex
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Figure 1: Case 5 : Pretreatment fundus photography (A) and fluorescein angiogram (B) reveals subfoveal choroidal neovascular membrane associated with hemorrhage. Posttreatment fundus photography (C) and fluorescein angiogram (D) at 9 months reveal marked enlargement, increased leakage, and disciform conversion of the neovascular complex

Mentions: In our study, treated CNV initially displayed a stabilization of visual acuity (defined as visual loss<3 lines) following PDT. Stabilization of visual acuity was achieved in four patients through the 12 months of follow-up. Visual improvement was obtained in one patient. The mean line change was -4.1 lines (ETDRS charts). Changes in GLD had a tendency to enlarge despite receiving PDT (Figure 1). The mean GLD at baseline was 2400±766.81 µm, and the mean GLD at the last examination was 3483±444.59 µm. In our experience PDT with verteporfin does not seem to be a good treatment to stabilize visual acuity and lesion size in CNV secondary to angioid streaks. However, compared to the aggressive natural course and to the limited treatment options, PDT may at least in part help to stabilize macular function over a limited period of time. We think that PDT should be considered in selected cases until better therapeutic modalities become available. In the future, modifications of the PDT treatment may have the potential to further improve the visual outcome in this population. As the combination of PDT with intravitreal triamcinolone acetonide showed promising results in a group of patients that did initially not show a good response to PDT treatment,17 and combinations of PDT with anti-angiogenic substances are currently investigated in clinical studies.18 We think that these combinations merit further investigation and might possibly enhance the results of the PDT treatment of patients with CNV and angioid streaks.


Photodynamic therapy with verteporfin for choroidal neovascularization in patients with angioid streaks.

Lee JM, Nam WH, Kim HK - Korean J Ophthalmol (2007)

Case 5 : Pretreatment fundus photography (A) and fluorescein angiogram (B) reveals subfoveal choroidal neovascular membrane associated with hemorrhage. Posttreatment fundus photography (C) and fluorescein angiogram (D) at 9 months reveal marked enlargement, increased leakage, and disciform conversion of the neovascular complex
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2629678&req=5

Figure 1: Case 5 : Pretreatment fundus photography (A) and fluorescein angiogram (B) reveals subfoveal choroidal neovascular membrane associated with hemorrhage. Posttreatment fundus photography (C) and fluorescein angiogram (D) at 9 months reveal marked enlargement, increased leakage, and disciform conversion of the neovascular complex
Mentions: In our study, treated CNV initially displayed a stabilization of visual acuity (defined as visual loss<3 lines) following PDT. Stabilization of visual acuity was achieved in four patients through the 12 months of follow-up. Visual improvement was obtained in one patient. The mean line change was -4.1 lines (ETDRS charts). Changes in GLD had a tendency to enlarge despite receiving PDT (Figure 1). The mean GLD at baseline was 2400±766.81 µm, and the mean GLD at the last examination was 3483±444.59 µm. In our experience PDT with verteporfin does not seem to be a good treatment to stabilize visual acuity and lesion size in CNV secondary to angioid streaks. However, compared to the aggressive natural course and to the limited treatment options, PDT may at least in part help to stabilize macular function over a limited period of time. We think that PDT should be considered in selected cases until better therapeutic modalities become available. In the future, modifications of the PDT treatment may have the potential to further improve the visual outcome in this population. As the combination of PDT with intravitreal triamcinolone acetonide showed promising results in a group of patients that did initially not show a good response to PDT treatment,17 and combinations of PDT with anti-angiogenic substances are currently investigated in clinical studies.18 We think that these combinations merit further investigation and might possibly enhance the results of the PDT treatment of patients with CNV and angioid streaks.

Bottom Line: Standardized protocol refraction, visual acuity testing, ophthalmologic examination, color photographs, fluorescein angiograms and indocyanin angiograms were used to evaluate the results of PDT with verteporfin.Main outcome measures were visual acuity and CNV size.The mean greatest linear dimension (GLD) at baseline was 2400+/-766.81 micrometer, and the mean GLD at the last examination was 3483+/-444.59 micrometer.

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology, Kangnam Sacred Heart Hospital, College of Medicine, Hallym University, Seoul, Korea.

ABSTRACT

Purpose: To evaluate the functional and anatomic outcomes of photodynamic therapy (PDT) for choroidal neovascularization (CNV) in patients with angioid streaks.

Methods: The authors retrospectively evaluated 6 consecutive patients (6 eyes) with CNV secondary to angioid streaks. All patients were treated with standard PDT with verteporfin protocol. Standardized protocol refraction, visual acuity testing, ophthalmologic examination, color photographs, fluorescein angiograms and indocyanin angiograms were used to evaluate the results of PDT with verteporfin. Main outcome measures were visual acuity and CNV size.

Results: Their mean age was 61.3+/-5.50 years (range, 53-68 years). Follow-up time ranged from 12 to 38 months with mean of 20.5+/-10.91 months. The mean visual acuity at baseline was 20/100 (range 20/25-20/500), and the mean visual acuity at the last examination was 20/320(range 20/125-counting finger). The mean greatest linear dimension (GLD) at baseline was 2400+/-766.81 micrometer, and the mean GLD at the last examination was 3483+/-444.59 micrometer.

Conclusions: PDT for CNV associated with angioid streaks seemed to slow down but not prevent the progression of the disease and associated visual loss.

Show MeSH
Related in: MedlinePlus