Severe pigment epithelial alterations in the treatment area following photodynamic therapy for classic choroidal neovascularization in young females

Postelmans, Laurence; Pasteels, Brigitte; Coquelet, Pascale; Ouardighi, Hind El; Verougstraete, Claire; Schmidt‐Erfurth, Ursula

doi:10.1016/j.ajo.2004.06.033

Cited by 78 publications

(53 citation statements)

References 13 publications

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“…This finding has also been described in PDT in other pathologies mainly in young female subjects [81, 82]. Wachtlin et al [82] suspect depigmentation or photobleaching of the RPE following PDT, leading to a window defect in the FA without loss of major functional properties.…”

Section: Treatment Of Cnv Due To Other Forms Of Amd and Different Undmentioning

confidence: 71%

Ocular Photodynamic Therapy – Standard Applications and New Indications (Part 1)

et al. 2007

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Ocular photodynamic therapy (PDT) was introduced as a novel treatment for neovascular forms of age-related macular degeneration and choroidal neovascularization (CNV) secondary to pathologic myopia in the mid/end 1990s. The current treatment recommendations are based on the results of two large, prospective, multicenter, randomized clinical trials (Treatment of Age-Related Macular Degeneration with Photodynamic Therapy and Verteporfin in Photodynamic Therapy Studies) and thousands of patients have been treated worldwide over the last years. Meanwhile, PDT has been performed in several other ocular pathologies with some remarkable results, however, with most reports being case reports and small case series without statistical significance. These extended applications include CNV secondary to choroiditis and retinochoroiditis, angioid streaks, central serous chorioretinopathy, retinal angiomatous proliferation, parafoveal telangiectasia or CNV associated with macular dystrophy and idiopathic CNV, as well as diseases without CNV, such as choroidal hemangioma, retinal hamartoma, choroidal melanoma, chronic central serous chorioretinopathy, angiomatous lesions secondary to systemic diseases, rubeosis iridis or neovascular glaucoma. To date, with the introduction of anti-VEGF therapy, the role of PDT will certainly change. However, it is reasonable to believe that it will maintain an important role in combination therapy due to its unique properties of selective vascular targeting. Therefore, it is essential for the ophthalmologist to be familiar with the extended applications and their modifications of treatment parameters. This review will summarize the standard and experimental applications of PDT based on our own results and the literature.

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Section: Treatment Of Cnv Due To Other Forms Of Amd and Different Undmentioning

confidence: 71%

Ocular Photodynamic Therapy – Standard Applications and New Indications (Part 1)

et al. 2007

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“…In the previously mentioned study 12% of treated eyes developed this complication [12]. PDT may cause pathologic changes of the RPE and breakdown of the outer blood-retinal barrier [13,14,15]. This effect on the already damaged RPE, due to the age-related macular degeneration, may further deteriorate the junctions between the RPE cells and predispose to the development of an RPE tear.…”

Section: Discussionmentioning

confidence: 99%

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

Ladas¹,

Kotsolis²,

Rouvas³

et al. 2007

Ophthalmologica

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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.

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“…window defects) following PDT were described in FA studies of young women [53, 54]. The authors suspected depigmentation or photobleaching of the RPE leading to a window defect in the FA without loss of the major RPE functional properties.…”

Section: Other Pdt Applications In Ophthalmologymentioning

confidence: 99%

“…New animal investigations have histologically shown more selective vessel occlusion for 100 mW/cm 2 rather than the high irradiance of 600 mW/cm 2 [73]. Documented side effects with RPE alterations and vaso-occlusive effects at the level of the choroid may be inhibited by adapting the treatment parameters [53, 54]. The breakdown of the outer blood-retinal barrier [71] and an increased concentration of VEGF following PDT [72] may be reduced by a combined therapy using anti-VEGF prior to PDT [74].…”

Section: Current and Future Applications: An Outlookmentioning

confidence: 99%

Ocular Photodynamic Therapy – Standard Applications and New Indications (Part 2)

et al. 2007

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Photodynamic therapy (PDT) has become a well-established treatment for vascular forms of age-related macular degeneration (AMD). The implementation of evidence-based medicine principles into the treatment regimen of AMD seems to be immensly important, since AMD continues to be the most frequent cause of blindness among patients older than 65 years in industrialized countries. Numerous randomized prospective studies demonstrated high levels of evidence for the efficacy of various treatment approaches such as laser photocoagulation, PDT, subretinal surgery or novel anti-angiogenic drugs [Arch Ophthalmol 2006;124:597–599]. The high evidence shown by these studies supported the rationale to use PDT also in additional, less frequent, vasoproliferative diseases. Although these ‘case series’ and ‘individual case control studies’ have a low level of evidence, they give us important information for treatment decisions in these rare conditions. The goal of this survey is to review the current literature regarding PDT in vasoproliferative and exudative ocular diseases outside AMD. Many studies modified the treatment parameters of PDT to address the specific pathology of the underlying disease. Table 1 summarizes the diseases and treatment parameters that are described in this part 2, the entire table of this review is included in part 1 (www.karger.com/doi/10.1159/ 000101922).

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Severe pigment epithelial alterations in the treatment area following photodynamic therapy for classic choroidal neovascularization in young females

Cited by 78 publications

References 13 publications

Ocular Photodynamic Therapy – Standard Applications and New Indications (Part 1)

Ocular Photodynamic Therapy – Standard Applications and New Indications (Part 1)

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

Ocular Photodynamic Therapy – Standard Applications and New Indications (Part 2)

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