Photodynamic therapy vs limited macular translocation in the management of subfoveal choroidal neovascularization in pathologic myopia: a two-year study.
OBJECTIVE
To compare the results of limited macular translocation and photodynamic therapy (PDT) in subfoveal choroidal neovascularization (CNV) attributable to pathologic myopia with a 24-month follow-up.


METHODS
Retrospective analysis of nonrandomized interventional clinical study.


METHODS
Retrospective review of 66 consecutive patients: 34 myopic eyes with subfoveal neovascularization treated by PDT and 32 operated on with the translocation technique. Translocation was considered principally when the lesion size was adequate (nasal inferior margin of the membrane less than half a disk diameter away from the center of the fovea) with duration of symptoms of less than four months. Main outcome measure was the postoperative change in visual acuity.


RESULTS
In the translocation group, mean gain in visual acuity was greater than in the PDT group (+2.8 lines and -1.8 line, respectively, P = .001). In the translocation group, 55% of eyes gained 3 lines or more at two years compared with 10% in the PDT group. Sixty percent of eyes in the translocation group vs 40% in the PDT group had an improvement of at least five letters. Mean foveal displacement after translocation was 906 mum; postoperative complications included retinal detachment (three eyes), macular fold (one eye), and transient diplopia (four eyes). In young patients, the postoperative gain was better in both groups. In the translocation group, mean survival time for choroidal neovascularization recurrence was 40 months for patients younger than 40 years and 20 months for older patients.


CONCLUSIONS
Translocation showed better results than PDT at two years. Further studies are required to confirm these findings.
Glacet-Bernard
Agnès
A
University Eye Clinic of Créteil, Intercommunal and Henri Mondor (Assistance Publique des Hôpitaux de Paris) Hospitals, University of Paris XII, 40 Avenue de Verdun, 94010 Créteil, France. agnes.glacet@chicreteil.fr
Benyelles
Nabil
N
Dumas
Stéphane
S
Haddad
Walid Michel
WM
Voigt
Monika
M
Razavi
Sam
S
Roquet
Wilfrid
W
Coscas
Gabriel
G
Soubrane
Gisèle
G
D020256:Choroidal Neovascularization / Q000188:drug therapy* / Q000209:etiology / Q000601:surgery*; D005260:Female; D005451:Fluorescein Angiography; D005584:Fovea Centralis; D006801:Humans; D008266:Macula Lutea / Q000637:transplantation*; D008297:Male; D008875:Middle Aged; D047728:Myopia, Degenerative / Q000150:complications*; D010778:Photochemotherapy; D012008:Recurrence; D012189:Retrospective Studies; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology*