Patients with ischaemic retinopathy who show iris neovascularization despite panretinal laser photocoagulation (PRP) very often develop a neovascular glaucoma. Photodynamic therapy (PDT) has been shown to occlude neovascularization without damage to physiologic vessels or adjacent tissue in the treatment of choroidal neovascularization (CNV) and might also be of value for patients with neovascular glaucoma who did not benefit from the PRP. First results of a monocentre, open label, intra-individual controlled, pilot phase I/II, dose-finding study demonstrate that PDT with verteporfin is capable of occluding neovascular vessels for a defined period of time without damaging adjacent tissue or physiologic iris vessels. Whether this vessel occlusion will have an impact on the progression of rubeosis or neovascular glaucoma will be the subject of further investigation.
Eye growth is regulated by a precise, sharp image of a distant object on the photoreceptor layer. A variety of laboratory investigations report that translucent occluders may induce axial eye elongation in animals. This axial growth is also called form deprivation myopia (FDM). In our pediatric ophthalmology clinic we observed the clinical correlate of FDM in a male infant with unilateral corneal ulcer due to a congenital tarsal malformation. Examination in the postnatal period under anesthesia revealed identical axial length in both eyes. Refraction of the affected eye could not be measured due to severe corneal ulcer. During an observation period of two years, the deep corneal opacification of the affected eye induced unilateral disproportionate axial elongation with formation of myopia. Formation of FDM may complicate treatment of amblyopia following unilateral media opacification. Periodic measurements of refraction should be performed to allow appropriate correction.
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