Clinical Study
Eye (2008) 22, 528–533; doi:10.1038/sj.eye.6702688; published online 19 January 2007
Photodynamic therapy combined with systemic corticosteroids for choroidal neovascularisation secondary to punctate inner choroidopathy
Presented as a poster at the Royal College of Ophthalmologists Annual Congress 2006
K C S Fong1, D Thomas1, K Amin1, D Inzerillo1 and S E Horgan1
1Royal Eye Unit, Kingston Hospital, Kingston-upon-Thames, Surrey, UK
Correspondence: KCS Fong, Moorfields Eye Hospital, Level 5 Lanesborough Wing, Blackshaw Road, London SW17 0QT, UK. Tel: +4420 8725 2064; Fax: +4420 8725 0372; E-mail: fongcsk@yahoo.co.uk
Received 29 June 2006; Revised 12 September 2006; Accepted 12 September 2006; Published online 19 January 2007.
Abstract
Aim
To report on visual acuity (VA) and angiographic outcomes in patients presenting with subfoveal choroidal neovascular membranes (CNV) secondary to punctate inner choroidopathy (PIC), treated with photodynamic therapy (PDT) with verteporfin combined with systemic corticosteroids.
Methods
A prospective case series of patients with subfoveal CNV secondary to PIC was analysed. All patients were treated with PDT combined with oral prednisolone (1 mg/kg body weight/day) which was started 5 days before PDT. Fluorescein angiography was performed at baseline and every 3 months post-treatment to establish the size, position, and activity of the CNV. Visual acuity was measured using the ETDRS scale. Further PDT treatment was carried out at follow-up visits if there was angiographic evidence of ongoing CNV activity.
Results
Five female patients with a mean age of 30.4 years (range 25–43 years) were treated over a 12-month period. The mean greatest linear diameter (GLD) of the CNV was 1.66 mm (range 0.46–3.28 mm). A mean improvement in vision of nine ETDRS letters (range - 15–20 letters) after treatment was found, which was maintained at final follow-up. The mean follow-up time was 12 months (range 10–14 months). The mean number of PDT treatments was two (range 1–3).
Conclusions:
The vaso-occlusive effect of PDT combined with the vasostatic and anti-inflammatory effect of systemic oral prednisolone appears to be a safe and effective option in the primary treatment of subfoveal CNV in patients with PIC.
Keywords:
photodynamic therapy, systemic corticosteroids, choroidal neovascularisation, punctate inner choroidopathy
