Aim To evaluate the efficacy of conventional argon laser for the treatment of serosanguineous maculopathy secondary to polypoidal choroidal vasculopathy (PCV). Methods A retrospective audit of patients who had argon laser photocoagulation to angiographically determined polypoidal lesions and subsequently followed up at 1, 3, 6, and 12 months post treatment. Results Twenty-one eyes (75%) had stable or improved vision at 12 months. Twenty-three eyes had extrafoveal, two eyes had juxtafoveal, and three eyes had subfoveal polyps. In the extrafoveal group, 18 eyes (78%) had stable or improved vision at 12 months. Eighteen eyes (64.3%) showed clinical or angiographic resolution of maculopathy. Three eyes (10.7%) had recurrence of polyps subfoveally, three eyes (10.7%) had subsequent choroidal neovascularisation, and four eyes (14.3%) had persistent leakage with neurosensory detachment. Conclusion In our study, 18 of the 23 eyes which had extrafoveal polyps had stable or improved best-corrected visual acuity and showed complete resolution of maculopathy at 12 months follow-up. Argon laser photocoagulation would appear to be most beneficial for extrafoveal PCV. However, in view of the retrospective nature of this study, the true efficacy of argon laser treatment would have to be evaluated with a larger, prospective and randomised controlled trial.
Aims To determine the correlation between systemic corticosteroid therapy and the occurrence and size of peripapillary atrophy (PPA) in patients with Vogt-Koyanagi-Harada (VKH) disease. Methods All patients with VKH disease were retrospectively reviewed for their corticosteroid regimen. The extent of the PPA, if present, was measured using digitized imaging software, by two masked observers. Eyes with myopia greater than 6 dioptres or glaucoma were excluded. The patients were classified into three groups: early high (EH), late high (LH), and low dose (LD), according to the dose and timing of corticosteroids received during the acute phase of the disease. Results There were 40 eyes in the EH group, 25 eyes in the LH group, and 23 eyes in the LD group. Multivariate analysis showed that corticosteroid therapy was the main determinant of PPA occurrence. All the eyes in the LD group had PPA and eyes in the LH groups were 4.02 times (95% confidence interval 1.24-13.07) more likely to develop PPA than those in the EH group. The LD group also had larger PPA to disc ratios than the EH group. (Mean of 2.83 vs 0.19, Po0.001) Conclusion The development and extent of PPA in patients with VKH disease appear to be dependent on the dose and timing of systemic corticosteroids.
Background To describe the efficacy of photodynamic therapy (PDT) with verteporfin for the treatment of polypoidal choroidal vasculopathy (PCV). Methods This is a retrospective interventional case series of 41 eyes of 40 patients with angiographic evidence of PCV, which had PDT with verteporfin. Pre-treatment best-corrected visual acuity (BCVA) was measured and patients were followed up for at least 12 months with BCVA recorded at each visit. Results The mean follow-up time was 23.7 months. Seven of 10 eyes (70%) with juxtafoveal lesions and 17 of 31 eyes (54.8%) with subfoveal lesions had stable or improved vision (loss of p3 lines) at the last follow-up. The mean number of treatments was 1.90. Thirty-three eyes (80.5%) had dry, quiescent scars at last follow-up, six eyes (14.6%) had persistent leakage, and two eyes (4.9%) had evidence of choroidal neovascularisation. Conclusion Our results indicate that 24 of 41 eyes (58.5%) with serosanguinous maculopathy secondary to PCV treated with PDT had stable or improved vision (loss of p3 lines) after a mean follow-up of almost 2 years. However, in view of the retrospective nature of this study, the true efficacy of PDT for PCV would have to be evaluated with a larger randomised controlled trial.
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