A preliminary study of photodynamic therapy using verteporfin for choroidal neovascularization in pathologic myopia, ocular histoplasmosis syndrome, angioid streaks, and idiopathic causes
Objective: To evaluate short-term safety and the effects on visual acuity and fluorescein angiography of single or multiple sessions of photodynamic therapy with verteporfin for choroidal neovascularization (CNV) not related to age-related macular degeneration (AMD), including pathologic myopia, the ocular histoplasmosis syndrome, angioid streaks, and idiopathic causes. Design: A nonrandomized, multicenter, open-label, dose-escalation phase 1 and 2 clinical trial. Setting: Four ophthalmic centers in Europe and North America providing retinal care. Participants: Thirteen patients with subfoveal CNV due to pathologic myopia, the ocular histoplasmosis syndrome,, angioid streaks, or idiopathic causes. Methods: Standardized protocol refraction, visual acuity testing, ophthalmic examinations, color photographs, and fluorescein angiograms were used to evaluate the results of photodynamic therapy treatments with verteporfin. Follow-up ranged from 12 weeks for patients who were treated once to 43 weeks for patients who were treated up to 4 times. Results: Verteporfin therapy was well tolerated in patients with CNV not related to AMD. No deterioration in visual acuity was observed; most patients gained at least 1 line of vision. Reduction in the size of leakage area from classic CNV was noted in all patients as early as 1 week after verteporfin therapy, with complete absence of leakage from classic CNV in almost half of the patients. Improvement in visual acuity after verteporfin therapy was greatest (+6, +8, and +9 lines) in 3 patients with relatively poor initial visual acuity (between 20/200 and 20/800). Up to 4 treatments were found to have short-term safety even with retreatment intervals as short as 4 weeks. Conclusions: Treatment of CNV not related to AMD with verteporfin therapy achieves short-term cessation of fluorescein leakage from CNV in a small number of patients without loss of vision. Further randomized clinical trials including a larger number of patients are under way to confirm whether verteporfin therapy is beneficial for subfoveal CNV not related to AMD.
Sickenberg, M. Univ Lausanne, Hop Ophtalm Jules Gonin, 15 Ave France, CH-1004 Lausanne, Switzerland Univ Lausanne, Hop Ophtalm Jules Gonin, CH-1004 Lausanne, Switzerland Univ Lubeck, Hosp Eye, Retina Dept, Lubeck, Germany Harvard Univ, Sch Med, Massachusetts Eye & Ear Infirm, Retina Serv, Boston, MA USA Univ Geneva, Hop Cantonal, Dept Oto Neuro Ophthalmol, CH-1211 Geneva, Switzerland Ecole Polytech Fed Lausanne, Dept Environm Engn, Lab Air Pollut Studies, Lausanne, Switzerland QLT PhotoTherapeut Inc, Vancouver, BC, Canada CIBA Vis Inc, Duluth, GA USA CIBA Vis AG, Bulach, Switzerland Johns Hopkins Univ, Sch Med, Johns Hopkins Hosp, Wilmer Ophthalmol Inst, Baltimore, MD USA
Times Cited: 34
Cited References Count: 22
Record created on 2011-02-01, modified on 2016-08-09