Photodynamic Therapy with Verteporfin for Subfoveal Choroidal Neovascularization in Vogt-Koyanagi-Harada Syndrome

PURPOSE: We present a case of photodynamic therapy (PDT) with verteporfin for choroidal neovascularization (CNV) complicated by Vogt-Koyanagi-Harada syndrome. METHODS: A 46-year-old male who had bilateral subfoveal CNV complicated by Vogt-Koyanagi-Harada syndrome underwent 3 sessions of PDT with verteporfin in 1 year. RESULTS: After 3 sessions of PDT with verteporfin, maintenance of visual acuity was achieved without any complication as alteration of retinal pigment epithelium and aggravation of intraocular inflammation, but subfoveal fibrosis developed. CONCLUSIONS: PDT with verteporfin is a good treatment method without any complication for the CNV complicated by Vogt-Koyanagi-Harada syndrome, even though multiple sessions were needed.

Clinical Outcomes of Scleral Buckle Encircling for the Retinal Detachment of Retinopathy of Prematurity

PURPOSE: To investigate the clinical outcomes of scleral buckle encircling surgery for the retinal detachment of retinopathy of prematurity (ROP). METHODS: The medical records of the patients who had undergone primary scleral buckle encircling for the retinal detachment of ROP (4A, 4B, 5) between January 1989 and March 2002 were retrospectively reviewed. RESULTS: Of the 59 patients (M:F ratio= 32:27, 83 eyes), the mean gestational age, birth weight, and follow-up period were 29.2 weeks, 1244gm, and 52.8 months respectively. Just before scleral buckle encircling surgery there were 48 eyes of stage 4A, 19 of stage 4B, and 16 of stage 5. Attachment of posterior pole retina was achieved in 66.7%, 63.2%, and 25% of eyes, respectively. Final best corrected visual acuity in eyes with attached posterior pole retina was generally poor, and the rate of vision over 20/1000 was 30.3% (10/33) in the verbal group and the rate of vision with moderate fix and follow was 75% (9/12) in the nonverbal group. The mean induced anisometropia after scleral buckle encircling surgery was -12.1 D. The mean reduced myopia after removal of scleral buckling material was 3.4 D. CONCLUSIONS: An anatomic success after scleral buckle encircling surgery in infant with retinal detachment of ROP was fairly achieved, but the final results depended on the extent of retinal detachment. Although the retina was attached after surgery, a severe degree of myopia developed and resulted in low vision. Therefore once retinal detachment develops in infants with ROP, early surgery is required. Furthermore, to maximize the vision, efforts for correcting refractive errors should be made intensively.