Efficacy of Photodynamic Therapy in the Management of Occult Choroidal Neovascularization Associated with Serous Pigment Epithelium Detachment

Abstract

Aims: To evaluate the efficacy of photodynamic therapy (PDT) in the treatment of subfoveal occult choroidal neovascularization (CNV) associated with serous pigment epithelium detachment (PED) in eyes with age-related macular degeneration. Methods: Hundred and fifty-three patients (161 eyes) with subfoveal occult CNV due to age-related macular degeneration, were divided into two groups. The first group (70 patients, 75 eyes) included eyes with occult CNV associated with serous PED of at least 1 disc diameter in size and the second (83 patients, 86 eyes) eyes with late leakage of undetermined source. All the patients were treated with PDT. The follow-up time ranged from 12 to 48 months. Results: At the last examination, in the first group, the visual acuity (VA) improved or remained stable in 17 (22.7%) and decreased in 58 (77.3%). In the second group, the VA improved or remained stable in 37 (43%) and decreased in 49 (57%). The difference in the change (decrease) in the VA between the two groups was statistically very significant (p = 0.0075). Retinal pigment epithelium tear occurred in 15 eyes (20%) of the first group. Conclusion: Our study showed that the visual prognosis of eyes treated with PDT due to subfoveal occult CNV associated with serous PED is not favorable. We believe that the distinction between the two forms of occult CNV is essential, as they carry a different prognosis.

Ranibizumab for the Treatment of Exudative Age-Related Macular Degeneration Associated With Retinal Pigment Epithelial Tear

“…Among the eyes of the Grade 4 group, the functional results remained unchanged, whether treatment was administered (7 eyes) or not (3 eyes). However, two of the seven eyes that were treated (ranibizumab [5] and bevacizumab [2]) had a better anatomical response. These two eyes received ranibizumab as an anti-VEGF treatment.…”

“…Many studies have reported on the development of RPE tears either spontaneously during the natural course of the disease or as a side effect of various treatments, including thermal laser, photodynamic therapy (PDT), pegaptanib (Macugen; Eyetech Pharmaceuticals, New York, NY), bevacizumab (Avastin; Genentech, Inc, South San Francisco, CA), or ranibizumab (Lucentis, Genentech, Inc). [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15] Even though RPE tear is considered a severe complication associated with significant visual loss, studies have shown that in many cases, the vision may be preserved. [8][9][10][11]15 In our study, we present our anatomical and functional results in patients with RPE tear associated with exudative AMD who were treated with intravitreal ranibizumab injections and followed-up for a median of 1 year.…”

One year results of anti-VEGF treatment in pigment epithelial detachment secondary to macular degeneration

“…In PDT studies, it has been reported that the VA of patients did not increase and that, in some cases, the patient's VA decreased due to the development of RPE tears, depending on the treatment or the natural course of the disease (14,15) . Consequently, on the basis of the association between PED and inflammation, IVTA treatment was added to the PDT.…”

The Effect of Intravitreal Anti-VEGF on the Pigment Epithelial Detachment in Eyes with the Exudative Type of Age-Related Macular Degeneration

“…2 Treatment options for CNV associated with PED in AMD, such as laser photocoagulation, photodynamic therapy, and/or intravitreal steroids, have been reported but lead to unsatisfactory or conflicting results. 3 There are, as yet, no established treatment recommendations for PED associated with CNV, most likely due to the fact that the development of PED and its natural course in AMD has not yet been fully investigated. In general, treatment of PEDs associated with CNV is particularly difficult due to the risk of development of an RPE tear.…”