Top

Published in:

01-08-2010 | Original Paper

Photodynamic therapy for choroidal neovascularization in young adult patients

Authors: Rita Ehrlich, Michal Kramer, Irit Rosenblatt, Dov Weinberger, Karin Mimouni, Ethan Priel, Ruth Axer-Siegel

Published in: International Ophthalmology | Issue 4/2010

Abstract

We report our experience with photodynamic therapy (PDT) in the treatment of choroidal neovascularization (CNV) in young adult patients. This was a retrospective study of young adults with CNV treated with PDT. Data collected included age, diagnosis, type and size of CNV, number of treatments, visual outcome, and side effects. Ten patients (11 eyes) were included in the study (mean age 27.2 ± 13.3 years). Etiologies included multifocal choroiditis (3 eyes), idiopathic CNV (5 eyes), central serous chorioretinopathy (1 eye), and toxoplasma (2 eye). The mean number of treatments was 2 ± 0.7 and the mean follow-up time was 13.1 ± 9.5 months. Initial visual acuity (VA) ranged from 20/25 to 20/1,200 (mean logMAR 0.6 ± 0.5), and improved to 20/20 to 20/250 (mean logMAR 0.46 ± 0.4) (P = 0.51). Of the four eyes that received additional treatment with oral steroids, one of which also received intravitreal bevacizumab (Avastin) injections, all had visual acuity improvement of 2 or more lines, while only two of seven eyes that received PDT alone showed such improvement. PDT can improve visual outcome in a subgroup of young patients with subfoveal CNV especially when supplemented with oral steroid and bevacizumab injections.

Treatment of Age-Related Macular Degeneration with Photodynamic Therapy (TAP) study group (1999) Photodynamic therapy of subfoveal choroidal neovascularization in age-related macular degeneration with verteporfin: one-year results of 2 randomised clinical trials—TAP report 1. Arch Ophthalmol 117:1329–1345

Bressler NM, Treatment of Age-Related Macular Degeneration with Photodynamic Therapy (TAP) study group (2001) Photodynamic therapy of subfoveal choroidal neovascularization in age-related macular degeneration with verteporfin: two-year results of 2 randomised clinical trials-TAP report 2. Arch Ophthalmol 119:198–207PubMed

Vertoporfin In Photodynamic (VIP) Therapy Study Group (2001) Verteporfin therapy of subfoveal choroidal neovascularization in age-related macular degeneration: two-year results of a randomized clinical trial including lesions with occult with no classic choroidal neovascularization-verteporfin in photodynamic therapy report 2. Am J Ophthalmol 131:541–560CrossRef

Blinder KJ, Blumenkranz MS, Bressler NM et al (2003) Verteporfin therapy of subfoveal choroidal neovascularization in pathologic myopia: 2-year results of a randomized clinical trial-VIP Report No. 3. Ophthalmology 110:667–673CrossRefPubMed

Wachtlin J, Heimann H, Behme T et al (2003) Long-term results after photodynamic therapy with verteporfin for choroidal neovascularizations secondary to inflammatory chorioretinal diseases. Graefe’s Arch Clin Exp Ophthalmol 241:899–906CrossRef

Ergun E, Tittl M, Stur M (2004) Photodynamic therapy with verteporfin in subfoveal choroidal neovascularization secondary to central serous chorioretinopathy. Arch Ophthalmol 122:37–41CrossRefPubMed

Browning AC, Chung AK, Ghanchi F, United Kingdom PDT Users Group et al (2005) Verteporfin photodynamic therapy of choroidal neovascularization in angioid streaks: one-year results of a prospective case series. Ophthalmology 112:1227–1231CrossRefPubMed

Fong KCS, Thomas D, Inzerillo D et al (2008) Photodynamic therapy combined with systemic corticosteroids for choroidal neovascularization secondary to punctuate inner choroidopathy. Eye 22:528–533CrossRefPubMed

Axer-Siegel R, Ehrlich R, Weinberger D et al (2004) Photodynamic therapy of subfoveal choroidal neovascularization in high myopia in a clinical setting: visual outcome in relation to age at onset. Am J Ophthalmol 138:602–607CrossRefPubMed

10.

Rosenfeld PJ, Brown DM, Heier JS, MARINA Study Group et al (2006) Ranibizumab for neovascular age related macular degeneration. N Engl J Med 355:1419–1431CrossRefPubMed

11.

Brown DM, Kaiser PK, Michels M, ANCHOR Study Group et al (2006) Ranibizumab versus verteporfin for neovascular age-related macular degeneration. N Engl J Med 355:1432–1444CrossRefPubMed

12.

Postelmans L, Pasteels B, Coquelet P et al (2004) Severe pigment epithelial alterations in the treatment area following photodynamic therapy for classic choroidal neovascularization in young females. Am J Ophthalmol 138(5):803–808CrossRefPubMed

13.

Schlötzer-Schrehardt U, Viestenz A, Naumann GO et al (2002) Dose-related structural effects of photodynamic therapy on choroidal and retinal structures of human eyes. Graefes Arch Clin Exp Ophthalmol 240:748–757CrossRefPubMed

14.

Wachtlin J, Behme T, Heimann H et al (2003) Concentric retinal pigment epithelium atrophy after a single photodynamic therapy. Graefes Arch Clin Ophthalmol 241:518–521CrossRef

15.

Grossniklaus HE, Green WR (1992) Pathologic findings in pathologic myopia. Retina 12:127–133CrossRefPubMed

16.

Kramer M (2005) Photodynamic therapy for inflammatory CNV: do we know enough? Ocul Immunol Inflamm 13:331–333CrossRefPubMed

17.

Rogers AH, Duker JS, Nichols N et al (2003) Photodynamic therapy of idiopathic and inflammatory choroidal neovascularization in young adults. Ophthalmology 110:1315–1320CrossRefPubMed

18.

Leslie T, Lois N, Christopoulou D et al (2005) Photodynamic therapy for inflammatory choroidal neovascularization unresponsive to immunosuppression. Br J Ophthalmol 89:147–150CrossRefPubMed

19.

Postelmans L, Pasteels B, Coquelet P et al (2005) Photodynamic therapy for subfoveal classic choroidal neovascularization related to punctate inner choroidopathy (PIC) or presumed ocular histoplasmosis-like syndrome (POHS-like). Ocul Immunol Inflamm 13:361–366CrossRefPubMed

20.

Hogan A, Behan U, Kilmartin DJ (2005) Outcomes after combination photodynamic therapy and immunosuppression for inflammatory subfoveal choroidal neovascularisation. Br J Ophthalmol 89:1109–1111CrossRefPubMed

21.

Spaide RF, Freund KB, Slakter J et al (2002) Treatment of subfoveal choroidal neovascularization associated with multifocal choroiditis and panuveitis with photodynamic therapy. Retina 22:545–549CrossRefPubMed

22.

Chan WM, Lai TY, Lau TT et al (2008) Combined photodynamic therapy and intravitreal triamcinolone for choroidal neovascularization secondary to punctuate inner choroidopathy or of idiopathic origin: one-year results of a prospective series. Retina 28:71–80CrossRefPubMed

23.

Luthra S, Narayanan R, Marques LE et al (2006) Evaluation of in vitro effects of bevacizumab (Avastin) on retinal pigment epithelial, neurosensory retinal, and microvascular endothelial cells. Retina 26:512–518CrossRefPubMed

24.

Mauget-Faÿsse M, Mimoun G, Ruiz-Moreno JM et al (2006) Verteporfin photodynamic therapy for choroidal neovascularization associated with toxoplasmic retinochoroiditis. Retina 26:396–403CrossRefPubMed

25.

Spaide RF, Martin ML, Slakter J et al (2002) Treatment of idiopathic subfoveal choroidal neovascular lesions using photodynamic therapy with verteporfin. Am J Ophthalmol 134:62–68CrossRefPubMed

26.

Lam A, Lee HC, Ho AC et al (2006) Photodynamic therapy in young patients. Ophthalmic Surg Lasers Imaging 37(3):182–189PubMed

27.

Chan WM, Lam DS, Wong TH et al (2003) Photodynamic therapy with vertoporfin for subfoveal idiopathic choroidal neovascularization: one-year results from a prospective case series. Ophthalmology 110:2395–2402CrossRefPubMed

28.

Mandal S, Garg S, Venkatesh P et al (2007) Intravitreal bevacizumab for subfoveal idiopathic choroidal neovascularization. Arch Ophthalmol 125:1487–1492CrossRefPubMed

29.

Gomi F, Nishida K, Oshima Y et al (2007) Intravitreal bevacizumab for idiopathic choroidal neovascularization after previous injection with posterior subtenon triamcinolone. Am J Ophthalmol 143:507–509CrossRefPubMed

30.

Chan WM, Lai TY, Liu DT et al (2007) Intravitreal bevacizumab (avastin) for choroidal neovascularization secondary to central serous chorioretinopathy, secondary to punctate inner choroidopathy, or of idiopathic origin. Am J Ophthalmol 143:977–983CrossRefPubMed

31.

Adán A, Mateo C, Navarro R et al (2007) Intravitreal bevacizumab (avastin) injection as primary treatment of inflammatory choroidal neovascularization. Retina 27:1180–1186CrossRefPubMed

32.

Nguyen QD, Shah SM, Hafiz G et al (2008) Intravenous bevacizumab causes regression of choroidal neovascularization secondary to diseases other than age related macular degeneration. Am J Ophthalmol 145:257–266CrossRefPubMed

33.

Mansour AM, Mackensen F, Arevalo JF et al (2008) Intravitreal bevacizumab in inflammatory ocular neovascularization. Am J Ophthalmol 146:410–416CrossRefPubMed

34.

Fine HF, Zhitomirsky I, Freund KB et al (2009) Bevacizumab (avastin) and ranibizumab (lucentis) for choroidal neovascularization in multifocal choroiditis. Retina 29:8–12CrossRefPubMed

Title: Photodynamic therapy for choroidal neovascularization in young adult patients
Authors: Rita Ehrlich
Michal Kramer
Irit Rosenblatt
Dov Weinberger
Karin Mimouni
Ethan Priel
Ruth Axer-Siegel
Publication date: 01-08-2010
Publisher: Springer Netherlands
Published in: International Ophthalmology / Issue 4/2010
Print ISSN: 0165-5701
Electronic ISSN: 1573-2630
DOI: https://doi.org/10.1007/s10792-010-9346-3

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Photodynamic therapy for choroidal neovascularization in young adult patients

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 4/2010

Successful treatment of choroidal neovascular membrane in retinitis pigmentosa with intravitreal bevacizumab

Pattern visual evoked potentials in the assessment of objective visual acuity in amblyopic children

Exfoliating goblet cell hyperplasia mimicking pterygium: a clinicopathological case report

Intra-ocular expression of vascular endothelial growth factor (VEGF) and pigment epithelial-derived factor (PEDF) in a case of Eales’ disease by immunohistochemical analysis: a case report

Descemet’s membrane detachment after cataract extraction surgery

Trachoma control in two Central Australian Aboriginal communities: a case study