Photodynamic therapy for occult choroidal neovascularization with pigment epithelium detachment in age-related macular degeneration.
OBJECTIVE
To study the visual and angiographic outcome of eyes with neovascular age-related macular degeneration associated with pigment epithelium detachment (PED) treated by photodynamic therapy.


METHODS
Review of the medical charts and the fluorescein and indocyanine green angiograms of all consecutive patients with age-related macular degeneration associated with choroidal neovascularization and serous PED of at least 1 disc diameter, who received photodynamic therapy from January 1, 2000, to August 31, 2002.


RESULTS
Thirty patients (34 eyes) met the study criteria. Each underwent 1 to 8 treatments (mean, 4); duration of follow-up was 12 to 36 months (mean, 19 months). Nineteen eyes (56%) lost 3 or more Snellen lines of visual acuity, 7 eyes (21%) lost 1 or 2 lines, 6 eyes (18%) maintained their initial acuity, and 2 eyes (6%) gained 1 or 2 lines. Subretinal hemorrhage occurred in 5 eyes and retinal pigment epithelium tears in 4 eyes. In 4 eyes, visual acuity decreased to counting fingers, hand motions, or light perception.


CONCLUSIONS
Although 44% of the 34 eyes with age-related macular degeneration and PED lost fewer than 3 Snellen lines in acuity, severe visual loss to counting fingers or less occurred in 4 eyes, 3 of them with choroidal neovascularization inside the PED. Further studies and treatment modalities are required to improve prognosis of neovascular age-related macular degeneration with serous PED.
Axer-Siegel
Ruth
R
Department of Ophthalmology, Rabin Medical Center, Beilinson Campus, Petah Tikva 49100, Israel. seegs@netvision.net.il
Ehrlich
Rita
R
Rosenblatt
Irit
I
Kramer
Michal
M
Priel
Ethan
E
Yassur
Yuval
Y
Weinberger
Dov
D
D000368:Aged; D000369:Aged, 80 and over; D020256:Choroidal Neovascularization / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D004396:Coloring Agents; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D007208:Indocyanine Green; D008268:Macular Degeneration / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D010778:Photochemotherapy; D017319:Photosensitizing Agents / Q000627:therapeutic use; D010857:Pigment Epithelium of Eye / Q000473:pathology*; D011166:Porphyrins / Q000627:therapeutic use; D012163:Retinal Detachment / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D016896:Treatment Outcome; D000077362:Verteporfin; D014792:Visual Acuity / Q000502:physiology
D004396:Coloring Agents; D017319:Photosensitizing Agents; D011166:Porphyrins; D000077362:Verteporfin; D007208:Indocyanine Green