Photodynamic therapy of subfoveal choroidal neovascularization in high myopia in a clinical setting: visual outcome in relation to age at treatment.
OBJECTIVE
To evaluate the visual outcome of patients with myopic subfoveal choroidal neovascularization (CNV) given photodynamic therapy (PDT) in a clinical setting, and to identify potential relation between the visual outcome and the age at treatment.


METHODS
Interventional case series.


METHODS
Retrospective comparative study.


METHODS
Outpatient ophthalmology clinic.


METHODS
Twenty-nine consecutive patients (30 eyes) with subfoveal CNV caused by pathologic myopia who were treated with verteporfin PDT from January 2000 to May 2003.


METHODS
All the patients received verteporfin PDT and were followed clinically and with fluorescein angiography (FA). Review of the medical records and angiograms was performed. Patients were divided into two groups by age, using the median age (60 years) as the cutoff.


METHODS
Visual acuity (VA) at the end of follow-up in the older-patient group compared with the younger-patient group.


RESULTS
The mean age was 63.1 years. Mean follow-up was 11.5 months. Patients received a mean of 3.48 treatments. Mean VA improved in the younger group from 0.63 to 0.39 logMAR (P = .02, paired t test) and deteriorated in the older group from 0.71 to 0.99 logMAR (P = .03, paired t test). In the whole cohort, 33% of eyes lost 3 or more lines of Snellen best-corrected VA; in the older age group, 50% of eyes lost 3 or more lines, whereas in the younger age group, only 8% of eyes did so (P = .024, Fisher's exact test).


CONCLUSIONS
In our consecutive case series, visual prognosis of myopic CNV after PDT was found to be influenced by age at treatment.
Department of Ophthalmology, Rabin Medical Center, Beilinson Campus, Petah Tiqva, Israel. seegs@netvision.net.il <seegs@netvision.net.il>
Ruth
R
Axer-Siegel
Rita
R
Ehrlich
Dov
D
Weinberger
Irit
I
Rosenblatt
Ludmila
L
Shani
Yuval
Y
Yassur
Ethan
E
Priel
Michal
M
Kramer
D000328:Adult; D017668:Age of Onset; D000368:Aged; D000369:Aged, 80 and over; D020256:Choroidal Neovascularization / Q000188:drug therapy* / Q000209:etiology; D005451:Fluorescein Angiography; D005584:Fovea Centralis; D006801:Humans; D008875:Middle Aged; D009216:Myopia / Q000150:complications*; D010778:Photochemotherapy; D017319:Photosensitizing Agents / Q000627:therapeutic use*; D011166:Porphyrins / Q000627:therapeutic use*; D012189:Retrospective Studies; D016896:Treatment Outcome; D000077362:Verteporfin; D014792:Visual Acuity / Q000502:physiology*
D017319:Photosensitizing Agents; D011166:Porphyrins; D000077362:Verteporfin