title: A preliminary study of photodynamic therapy using verteporfin for choroidal neovascularization in pathologic myopia, ocular histoplasmosis syndrome, angioid streaks, and idiopathic causes.
abstract: 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.
  
  
  METHODS
  A nonrandomized, multicenter, open-label, dose-escalation phase 1 and 2 clinical trial.
  
  
  METHODS
  Four ophthalmic centers in Europe and North America providing retinal care.
  
  
  METHODS
  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.
authors.affiliation: Hopital Ophtalmique Jules Gonin, Lausanne, Switzerland. michel.sickenberg@hospvd.ch
authors.forename: M
authors.initials: M
authors.lastname: Sickenberg
authors.forename: U
authors.initials: U
authors.lastname: Schmidt-Erfurth
authors.forename: J W
authors.initials: JW
authors.lastname: Miller
authors.forename: C J
authors.initials: CJ
authors.lastname: Pournaras
authors.forename: L
authors.initials: L
authors.lastname: Zografos
authors.forename: B
authors.initials: B
authors.lastname: Piguet
authors.forename: G
authors.initials: G
authors.lastname: Donati
authors.forename: H
authors.initials: H
authors.lastname: Laqua
authors.forename: I
authors.initials: I
authors.lastname: Barbazetto
authors.forename: E S
authors.initials: ES
authors.lastname: Gragoudas
authors.forename: A M
authors.initials: AM
authors.lastname: Lane
authors.forename: R
authors.initials: R
authors.lastname: Birngruber
authors.forename: H
authors.initials: H
authors.lastname: van den Bergh
authors.forename: H A
authors.initials: HA
authors.lastname: Strong
authors.forename: U
authors.initials: U
authors.lastname: Manjuris
authors.forename: T
authors.initials: T
authors.lastname: Gray
authors.forename: M
authors.initials: M
authors.lastname: Fsadni
authors.forename: N M
authors.initials: NM
authors.lastname: Bressler
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000793:Angioid Streaks / Q000150:complications*; D002199:Capillary Permeability; D020256:Choroidal Neovascularization / Q000188:drug therapy* / Q000209:etiology; D015821:Eye Infections, Fungal / Q000150:complications*; D005260:Female; D005451:Fluorescein Angiography; D005654:Fundus Oculi; D006660:Histoplasmosis / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009216:Myopia / Q000150:complications*; D010778:Photochemotherapy; D017319:Photosensitizing Agents / Q000627:therapeutic use*; D011166:Porphyrins / Q000627:therapeutic use*; D012449:Safety; D000077362:Verteporfin; D014792:Visual Acuity
chemical_list: D017319:Photosensitizing Agents; D011166:Porphyrins; D000077362:Verteporfin