Long-term results after photodynamic therapy with verteporfin for choroidal neovascularizations secondary to inflammatory chorioretinal diseases.

BACKGROUND

To evaluate the safety and the long-term effect on visual acuity of photodynamic therapy (PDT) for sub- and juxtafoveal choroidal neovascularizations (CNV) secondary to inflammatory conditions.

METHODS

In a prospective pilot study, 19 patients with CNV due to inflammatory conditions underwent PDT treatment with verteporfin with standard parameters. Regular follow-up was carried out every 3 months with ETDRS visual acuity measurement and fluorescein angiography. The initial diagnosis included punctate inner choroidopathy (PIC) ( n=7), presumed ocular histoplasmosis syndrome (POHS) (6), multifocal choroiditis with panuveitis (MCP) (2) and other inflammatory conditions (4).

RESULTS

All patients had a minimum follow-up of one year. After a mean follow-up of 22.1 months, the mean change in visual acuity was +1.63 ETDRS lines. At their last visit, all eyes showed a disappearance of pretreatment leakage in fluorescein angiography and 63.2% (12/19) eyes had an improvement of 2 or more lines, while 26.3% (5/19) remained stable (+/-1 line) and 10.5% (2/19) lost 2 or more lines. A mean of 2.0 (1-5) treatments was performed. No clinically relevant side effects or complications were observed.

CONCLUSIONS

PDT is a safe and effective treatment option for CNV secondary to inflammatory conditions. The results are better than for CNV secondary to AMD. For juxtafoveal CNV, the results are similar to those of subfoveal CNV with no additional safety concerns. Based on this observation, we consider PDT as treatment of choice for subfoveal CNV secondary to inflammatory chorioretinal diseases and for selected cases with juxtafoveal CNV.