This article is more than 5 years old. Information may no longer be current.
PDT more effective for myopic CNV in patients 55 years and younger, study finds
Click Here to Manage Email Alerts
Performing photodynamic therapy for choroidal neovascularization in eyes with pathologic myopia appears more effective in patients age 55 years and younger compared with older patients, a prospective study found.
"The incoming era of anti-VEGF [vascular endothelial growth factor] drugs will certainly offer new therapeutic opportunities also in combination, but verteporfin [Visudyne, Novartis] PDT ... appears to be the most suitable treatment option for myopic eyes with juxtafoveal CNV attributable to its simplicity of treatment, optimal selectivity and good safety profile," the study authors said.
Alfredo Pece, MD, of Melegnano Hospital in Milan, Italy, and colleagues evaluated outcomes of 49 eyes of 48 patients treated with verteporfin PDT for juxtafoveal CNV secondary to pathologic myopia. Their results are published in the March issue of the American Journal of Ophthalmology.
The researchers found that visual acuity improved from a mean of 20/55 at baseline to 20/44 at 48 months follow-up. Final visual acuity improved in 18 eyes (37%), decreased in 12 eyes (24%) and remained stable in 19 eyes (39%), according to the study.
Eyes that improved vision gained an average of 2.15 lines; 13 eyes (26.5%) improved at least three lines and five eyes (10%) gained two lines. Among eyes that lost vision, the average loss was 2.4 lines, with 10 eyes (20.5%) losing three or more lines and two eyes (4%) losing two lines, according to the study.
The authors noted that patients age 55 years or younger had significantly better final visual acuities compared with those older than 55 years (P = .01). Among younger patients, 82% had stable or improved vision and 18% lost a median of 2.5 lines. In contrast, 68% of the older patients had stable or improved vision at final follow-up and 32% lost a median of 2.3 lines, according to the study.
"One possible explanation for this observation is that the RPE [retinal pigment epithelium] may be healthier in younger patients," the authors said. "As a result, the development of CNV may be limited by the hyperplastic stimulation of PDT-regenerated RPE that can be layered within and over the CNV."
Baseline refractive error and CNV lesion size did not influence final visual outcomes, they noted.