Stabilization of visual acuity with photodynamic therapy in eyes with chorioretinal anastomoses

Abstract

The natural history of AMD eyes with CRA leads to progressive and dramatic VA loss, which is associated with blindness in most of the cases. PDT with verteporfin can offer some benefit to these patients, allowing VA stabilization or improvement in more than two thirds of the cases, at one year.

Photodynamic therapy with verteporfin for retinal angiomatous proliferation

“…Reviewing our experience with PDT in 13 eyes with ARMD with RAP and PED, we found it effective for small lesions, whereas it was associated with an acute retinal pigment epithelium tear in three cases (23%) [4]. In view of the uncertainties in the treatment of RAP [2,19], we evaluated the efficacy of PDT using verteporfin in patients with ARMD and RAP associated with PED and/or CNVs on a larger number of eyes with a longer follow-up period.…”

“…In contrast, the five lesions exceeding six disc areas had a bad anatomical and visual outcome. Silva and co-authors [19] found stabilization of visual acuity (VA) with PDT in eyes with chorioretinal anastomosis, offering some benefit in comparison with the natural course of the disease. Similar to our results, they reported BCVA loss of more than three lines in 35.3%, and severe VA loss in 20% of the eyes, with a worse prognosis for eyes with larger PED.…”

“…Photodynamic therapy (PDT) with verteporfin has been shown to be safe and efficacious in the treatment of predominantly classic CNV [22][23][24], and of occult and no classic CNV after 2 years of treatment [25,26]. Recently, few reports have suggested some efficacy of PDT with verteporfin in eyes with RAP associated with PED and/or CNV [19], even in the presence of visual and anatomical complications [2,4].…”

Long-Term Management of RAP Lesions in Clinical Practice: Treatment Efficacy and Predictors of Functional Improvement

“…Over the past years, the success rate of the various available treatments has been inconsistent. Nevertheless, some authors report relative stabilization of the disease with treatment, either PDT [13,14] or IV ranibizumab [18,19,21]. PDT was combined with IV ranibizumab [18,24] or even IV triamcinolone [18].…”

“…While several treatment approaches proved unsuccessful in the past [13,14,15,16,17], the blockage of vascular endothelium growth factor (VEGF) has substantially changed the prognosis of this condition. Reports on intravitreal (IV) ranibizumab, either in monotherapy or with concomitant photodynamic therapy (PDT), have underlined the responsiveness of RAP lesions to both treatment modalities [18,19,20,21].…”