Photodynamic Therapy for Choroidal Neovascularization in Angioid Streaks

Ja Young Jung; Sung Won Cho; Jae Heung Lee

doi:10.3341/jkos.2007.48.11.1593

Journal List > J Korean Ophthalmol Soc > v.48(11) > 1007977

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Jung, Cho, and Lee: Photodynamic Therapy for Choroidal Neovascularization in Angioid Streaks

Original Article

J Korean Ophthalmol Soc 2007;48(11):1593-1598.

Published online: 28 August 2007

DOI: https://doi.org/10.3341/jkos.2007.48.11.1593

Photodynamic Therapy for Choroidal Neovascularization in Angioid Streaks

Ja Young Jung, M.D., Sung Won Cho, M.D., Ph.D., Jae Heung Lee, M.D., Ph.D.

Myung-Gok Eye Research Institute, Department of Ophthalmology, Konyang University, Kim's Eye Hospital, Seoul, Korea

Address reprint requests to Sung Won Cho, M.D., Ph.D., Department of Ophthalmology, Kim's Eye Hospital, College of Medicine, Konyang University, #156 Youngdeungpo-dong 4ga, Youngdeungpo-gu, Seoul 150-034, Korea, Tel: 82-2-2639-7777, Fax: 82-2-2633-3976, E-mail: eyecure@hotmail.com

Received 22 November 2006 Accepted 4 July 2007

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To evaluate the efficacy of photodynamic therapy (PDT) with verteporfin in the management of choroidal neovascularization (CNV) associated with angioid streaks.

Case summary

Six eyes of four patients with CNV due to angioid streaks were treated with photodynamic therapy with verteporfin. Visual acuity testing, ophthalmologic examinations, photographs, and fluorescein angiograms were used to evaluate the results of PDT. Two of six eyes had subfoveal lesions, while four eyes had juxtafoveal lesions on initial examination. Conversion from a CNV to a fibrous scar lesion following PDT was observed in four eyes. Enlargement of the CNV was documented in two eyes at the final follow-up. Of a total of 6 eyes, the final best-corrected visual acuity decreased in 4 eyes and stabilized in 2 eyes.

Conclusions

Photodynamic therapy can achieve short-term cessation or decrease of fluorescein leakage from chroidal neovascularization associated with angioid streaks. However, it does not alter the course of this disease, and multiple sessions are needed. Visual prognosis is poor.

Keywords: Angioid streaks, Photodynamic therapy

References

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Figure 1.

Case 3. Fundus photographs and angiographic photographs of both eyes before PDT. (A) Fundus photograph shows choroidal neovascularization with subretinal hemorrhage. (B) Fundus photograph shows macular edema. (C) Angiographic photograph shows hyperfluorescence due to choroidal neovascularization and adjacent blocked fluorescence due to hemorrhage. (D) Angiographic photograph shows hyperfluorescence due to choroidal neovascularization.

Figure 2.

Case 3. Fundus photographs and angiographic photographs of both eyes after 5 sessions of PDT. (A)(B) Fundus photograph of the both eyes shows that CNV has changed into fibrotic tissue. (C)(D) Angiographic photograph after 5 sessions of PDT. Angiographic photograph shows no leakage within the area of the lesion, but staining on the fibrous CNV lesion.

Table 1.

Individual Data of 6 Eyes (4 Patients) With Choroidal Neovascularization

Patient	Side	CNV location	Initial visual acuity	Final visual acuity	No. of treatment	Outcome
1	OD	Juxtafoveal	20/20	20/100	2	Larger
1	OS	Juxtafoveal	20/320	20/320	2	Larger
2	OS	Subfoveal	20/60	20/100	3	Stable, scar
3	OD	Juxtafoveal	Finger count	Finger count	4	Stable, scar
3	OS	Juxtafoveal	20/30	Finger count	5	Stable, scar
4	OD	subfoveal	20/50	20/200	3	Stable, scar

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