Outcomes after combination photodynamic therapy and immunosuppression for inflammatory subfoveal choroidal neovascularisation.
OBJECTIVE
To report the visual and angiographic outcomes after combination photodynamic therapy (PDT) and immunosuppression for inflammatory subfoveal choroidal neovascularisation (CNV).


METHODS
Retrospective review of six consecutive patients, five female and one male, aged 23-40 years with active subfoveal CNV secondary to posterior uveitis. Patients received either intravitreal triamcinolone or systemic immunosuppression (mycophenolate mofetil, tacrolimus) and PDT. Five patients had intravitreal triamcinolone injections and two patients were on systemic immunosuppression; all patients underwent PDT (mean two treatments). Visual acuity was measured on a 2 metre ETDRS chart and fluorescein angiograms were performed at each visit.


RESULTS
Median follow up was 15 months (range 10-31). Vision improved by a median of 13 letters in five patients and remained stable (+/-1 letter) in one patient. Median visual acuity improved from 20/160 at presentation to 20/40 at latest follow up (p=0.03). There was a reduction in clinical exudation and cessation of angiographic leakage in all six patients. All interventions were well tolerated.


CONCLUSIONS
Combination PDT and immunosuppression may be a useful therapeutic option for young patients with active inflammatory subfoveal CNV.
Hogan
A
A
Research Foundation, Royal Victoria Eye and Ear Hospital, Adelaide Road, Dublin 2, Ireland.
Behan
U
U
Kilmartin
D J
DJ
D000328:Adult; D000890:Anti-Infective Agents / Q000627:therapeutic use; D020256:Choroidal Neovascularization / Q000188:drug therapy*; D003131:Combined Modality Therapy; D005260:Female; D005451:Fluorescein Angiography; D005500:Follow-Up Studies; D006801:Humans; D007165:Immunosuppression Therapy; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008297:Male; D009173:Mycophenolic Acid / Q000031:analogs & derivatives / Q000627:therapeutic use; D010778:Photochemotherapy; D012189:Retrospective Studies; D016559:Tacrolimus / Q000627:therapeutic use; D016896:Treatment Outcome; D014221:Triamcinolone / Q000627:therapeutic use; D014792:Visual Acuity
D000890:Anti-Infective Agents; D007166:Immunosuppressive Agents; D014221:Triamcinolone; D009173:Mycophenolic Acid; D016559:Tacrolimus