1/3. A preliminary study of photodynamic therapy using verteporfin for choroidal neovascularization in pathologic myopia, ocular histoplasmosis syndrome, angioid streaks, and idiopathic causes.OBJECTIVE: To evaluate short-term safety and the effects on visual acuity and fluorescein angiography of single or multiple sessions of photodynamic therapy with verteporfin for choroidal neovascularization (CNV) not related to age-related macular degeneration (AMD), including pathologic myopia, the ocular histoplasmosis syndrome, angioid streaks, and idiopathic causes. DESIGN: A nonrandomized, multicenter, open-label, dose-escalation phase 1 and 2 clinical trial. SETTING: Four ophthalmic centers in europe and north america providing retinal care. PARTICIPANTS: Thirteen patients with subfoveal CNV due to pathologic myopia, the ocular histoplasmosis syndrome, angioid streaks, or idiopathic causes. methods: Standardized protocol refraction, visual acuity testing, ophthalmic examinations, color photographs, and fluorescein angiograms were used to evaluate the results of photodynamic therapy treatments with verteporfin. Follow-up ranged from 12 weeks for patients who were treated once to 43 weeks for patients who were treated up to 4 times. RESULTS: Verteporfin therapy was well tolerated in patients with CNV not related to AMD. No deterioration in visual acuity was observed; most patients gained at least 1 line of vision. Reduction in the size of leakage area from classic CNV was noted in all patients as early as 1 week after verteporfin therapy, with complete absence of leakage from classic CNV in almost half of the patients. Improvement in visual acuity after verteporfin therapy was greatest ( 6, 8, and 9 lines) in 3 patients with relatively poor initial visual acuity (between 20/200 and 20/800). Up to 4 treatments were found to have short-term safety even with retreatment intervals as short as 4 weeks. CONCLUSIONS: Treatment of CNV not related to AMD with verteporfin therapy achieves short-term cessation of fluorescein leakage from CNV in a small number of patients without loss of vision. Further randomized clinical trials including a larger number of patients are under way to confirm whether verteporfin therapy is beneficial for subfoveal CNV not related to AMD.- - - - - - - - - - ranking = 1keywords = angioid streak, angioid, streak (Clic here for more details about this article) |
2/3. Macular translocation for subfoveal choroidal neovascularization in angioid streaks.PURPOSE: To report a case of visual improvement after macular translocation performed for a subfoveal choroidal neovascular membrane in a patient with pseudoxanthoma elasticum and angioid streaks. methods: The fovea was translocated inferiorly by scleral imbrication, intentional retinal detachment with a small posterior retinotomy, and partial fluid-air exchange. The choroidal neovascular membrane was photocoagulated 1 week later. RESULTS: The visual acuity of the patient improved from 20/125 to 20/40. The center of the foveal avascular zone was moved inferiorly 844 microm. The choroidal neovascular membrane was extrafoveal after translocation and was treated with laser photocoagulation. CONCLUSION: Macular translocation may be considered in the management of subfoveal choroidal neovascular membrane in patients with pseudoxanthoma elasticum and angioid streaks.- - - - - - - - - - ranking = 2.1113600377218keywords = angioid streak, angioid, streak (Clic here for more details about this article) |
3/3. Photodynamic therapy of idiopathic and inflammatory choroidal neovascularization in young adults.PURPOSE: To evaluate the treatment of subfoveal choroidal neovascularization (CNV) using photodynamic therapy (PDT) with verteporfin (Visudyne; Novartis, Duluth, GA) in young adults. DESIGN: Retrospective noncomparative interventional case series. PARTICIPANTS: Nineteen eyes of 17 patients with classic, subfoveal CNV treated with PDT using verteporfin, excluding eyes with CNV secondary to age-related macular degeneration, angioid streaks, and myopia. MAIN OUTCOME MEASURES: Snellen visual acuity before and after PDT. RESULTS: Nineteen eyes were followed an average of 12.8 months (range, 4-33 months) after PDT. Before treatment, visual acuity measured > or = 20/40 in 0 eyes (0.0%), < 20/40 to > 20/200 in 11 eyes (57.9%), and < or =20/200 in 8 eyes (42.1%). After treatment, visual acuity measured > or =20/40 in four eyes (21.1%), < 20/40 to > 20/200 in eight eyes (42.1%), and < or =20/200 in seven eyes (36.8%). Six eyes (31.6%) underwent retreatment, with only two eyes retreated twice. Four eyes underwent eventual surgical removal of the CNV after PDT. CONCLUSIONS: Photodynamic therapy seems to be useful in stabilizing and improving visual acuity in young adults with subfoveal CNV secondary to idiopathic and inflammatory etiologies.- - - - - - - - - - ranking = 0.3518933396203keywords = angioid streak, angioid, streak (Clic here for more details about this article) |