Photodynamic therapy with verteporfin for retinal angiomatous proliferation.
OBJECTIVE
The aim of this study was to evaluate the results of photodynamic therapy (PDT), using verteporfin, for subfoveal neovascular age-related macular degeneration (ARMD) with retinal angiomatous proliferation (RAP) with pigment epithelial detachment (PED) and/or choroidal neovascularization (CNV).


METHODS
In this non-comparative, consecutive, interventional, case series, the data on 21 eyes (19 with stage 2 and two with stage 3 RAP) of 20 patients were reviewed. Serous PED occupied more than 50% of the lesion in 19 eyes. PDT was performed as per TAP protocol. Biomicroscopy and fluorescein and indocyanine-green angiography were performed to evaluate anatomical results and need for retreatment. Changes from baseline in best-corrected visual acuity (BCVA), and complications, were assessed.


RESULTS
A mean of 3.5+/-0.9 treatments was performed. After 13.7+/-2.2 months, mean BCVA decreased from 20/80 to 20/174 (P=0.0063). In six eyes (28.6%) BCVA remained stable, whereas in 15 eyes (71.5%) it decreased. Occlusion of RAP and flattening of PED was observed in three (14.2%) eyes, conversion to disciform lesion in one (4.7%), and persistence of PED in 11 eyes (52.3%). One eye (4.7%) evolved to haemorrhagic PED, and one (4.7%) toward stage 3 RAP. A tear in the retinal pigment epithelium (RPE) was observed in four eyes (19%). Eleven (52.3%) showed progression of leakage, six moderate leakage (28.6%), and three (14.2%) absence of leakage.


CONCLUSIONS
Timely PDT with verteporfin in the early stages in eyes with smaller lesions has the potential for a beneficial effect on vision, whereas it might worsen the natural course of larger lesions, with most eyes undergoing enlargement, disciform transformation or RPE tear.
Boscia
Francesco
F
Dipartimento di Oftalmologia ed Otorinolaringoiatria, Università di Bari, Piazza Giulio Cesare 11, Bari, Italy. francescoboscia@hotmail.com
Parodi
Maurizio Battaglia
MB
Furino
Claudio
C
Reibaldi
Michele
M
Sborgia
Carlo
C
D000368:Aged; D000369:Aged, 80 and over; D000798:Angiomatosis / Q000175:diagnosis / Q000188:drug therapy*; D020256:Choroidal Neovascularization / Q000175:diagnosis / Q000188:drug therapy; D004396:Coloring Agents; D005260:Female; D005451:Fluorescein Angiography; D005500:Follow-Up Studies; D006801:Humans; D007208:Indocyanine Green; D008268:Macular Degeneration / Q000175:diagnosis / Q000188:drug therapy*; 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 / Q000175:diagnosis / Q000188:drug therapy; D015861:Retinal Neovascularization / Q000175:diagnosis / Q000188:drug therapy*; D016896:Treatment Outcome; D000077362:Verteporfin; D014792:Visual Acuity
D004396:Coloring Agents; D017319:Photosensitizing Agents; D011166:Porphyrins; D000077362:Verteporfin; D007208:Indocyanine Green