Photodynamic therapy for occult choroidal neovascularization with pigment epithelium detachment in age-related macular degeneration

Arch Ophthalmol. 2004 Apr;122(4):453-9. doi: 10.1001/archopht.122.4.453.

Abstract

Objective: To study the visual and angiographic outcome of eyes with neovascular age-related macular degeneration associated with pigment epithelium detachment (PED) treated by photodynamic therapy.

Methods: Review of the medical charts and the fluorescein and indocyanine green angiograms of all consecutive patients with age-related macular degeneration associated with choroidal neovascularization and serous PED of at least 1 disc diameter, who received photodynamic therapy from January 1, 2000, to August 31, 2002.

Results: Thirty patients (34 eyes) met the study criteria. Each underwent 1 to 8 treatments (mean, 4); duration of follow-up was 12 to 36 months (mean, 19 months). Nineteen eyes (56%) lost 3 or more Snellen lines of visual acuity, 7 eyes (21%) lost 1 or 2 lines, 6 eyes (18%) maintained their initial acuity, and 2 eyes (6%) gained 1 or 2 lines. Subretinal hemorrhage occurred in 5 eyes and retinal pigment epithelium tears in 4 eyes. In 4 eyes, visual acuity decreased to counting fingers, hand motions, or light perception.

Conclusions: Although 44% of the 34 eyes with age-related macular degeneration and PED lost fewer than 3 Snellen lines in acuity, severe visual loss to counting fingers or less occurred in 4 eyes, 3 of them with choroidal neovascularization inside the PED. Further studies and treatment modalities are required to improve prognosis of neovascular age-related macular degeneration with serous PED.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Choroidal Neovascularization / drug therapy*
  • Choroidal Neovascularization / etiology
  • Choroidal Neovascularization / physiopathology
  • Coloring Agents
  • Female
  • Fluorescein Angiography
  • Humans
  • Indocyanine Green
  • Macular Degeneration / complications
  • Macular Degeneration / drug therapy*
  • Macular Degeneration / physiopathology
  • Male
  • Middle Aged
  • Photochemotherapy*
  • Photosensitizing Agents / therapeutic use
  • Pigment Epithelium of Eye / pathology*
  • Porphyrins / therapeutic use
  • Retinal Detachment / drug therapy*
  • Retinal Detachment / etiology
  • Retinal Detachment / physiopathology
  • Treatment Outcome
  • Verteporfin
  • Visual Acuity / physiology

Substances

  • Coloring Agents
  • Photosensitizing Agents
  • Porphyrins
  • Verteporfin
  • Indocyanine Green