Long-term results of photodynamic therapy for the treatment of choroidal neovascularization secondary to angioid streaks.

Purpose: To evaluate the anatomic-functional results and complications associated with the use of photodynamic therapy (PDT) with verteporfin in the treatment of choroidal neovascularization (CNV) secondary to angioid streaks (AS).

Methods: The authors retrospectively evaluated 10 consecutive patients (10 eyes) with CNV secondary to AS. All patients were treated with standard PDT with verteporfin protocol. The primary outcome to evaluate was the proportion of cases that lost < 3 lines of visual acuity (VA) measured on ETDRS charts. Secondary outcomes were changes in the greatest linear dimension (GLD) and in the area of the lesion. Seven previously examined patients were used as a control group.

Results: The mean duration of follow-up was 18 months (SD 9.2, range 6-36 months). In nine cases CNV was subfoveal and in one case, juxtafoveal. Mean VA was 20/126 at baseline (range 20/40-20/320) and 20/500 at the final examination (range 20/64-20/800). Three patients (30%) lost< 3 lines of VA. Four patients (40%) lost > or =6 lines of VA. The mean line change was -4.9 lines. The mean GLD went from 2861 microm at baseline (SD 1086.6, range 1350-4300 microm) to 4452 microm at last visit (SD 2564.2, range 1260-9450 microm). The mean area of the lesion was 3.78 mm(2) at baseline (SD 1.9, range 1.0-5.7 mm(2)) and 12.1 mm(2) at the final examination (SD 15.1, range 0.8-50.6 mm(2)). One patient developed a subfoveal rip of the retinal pigment epithelium. In the control group, the mean duration of follow-up was 15 months (SD 2.4, range 12-18 months). At baseline, the mean VA was 20/160 (range 20/100-20/320) and the mean GLD was 2685 microm (SD 676.8, range 1800-3500 microm). At the last examination, mean VA was 20/640 (range: 20/400-20/800) and mean GLD was 5528 microm (SD 2106.90, range 3500-8000 microm).

Conclusion: PDT with verteporfin does not seem to be a good treatment for stabilization of VA and lesion size in CNV secondary to AS, although the overall results seem to be slightly better in the group of patients treated with PDT than in the control group.