Photodynamic therapy for choroidal neovascularization on late-onset fundus flavimaculatus.

PURPOSE: To report the features of three consecutive cases of patients affected with late-onset fundus flavimaculatus (FFM) complicated with choroidal new vessels (CNV) and treated with photodynamic therapy (PDT). DESIGN: Retrospective interventional case series. METHODS: Three unrelated women (70- to 74-year-old) presented with unilateral decrease of central vision. Diagnosis of FFM and unilateral CNV was made after fundus examination and fluorescein angiography (FA). PDT was performed on the basis of FA features. RESULTS: One to three PDTs were needed for the treatment of CNV. At the end of follow-up (15-24 months), no leakage was present and visual acuity was improved in these three cases. CONCLUSIONS: Occurrence of CNV is a rare event in FFM. In these three eyes, PDT successfully stopped the progression of CNV and blocked leakage. We suggest considering PDT as a treatment for CNV in patients affected with FFM.

Limited macular translocation compared with photodynamic therapy in the management of subfoveal choroidal neovascularization in age-related macular degeneration.

PURPOSE: To compare the visual outcome of macular translocation (MT) versus photodynamic therapy (PDT) for subfoveal predominantly classic neovascularization in age-related macular degeneration (AMD). DESIGN: Nonrandomized clinical trial. METHODS: Retrospective review of 65 consecutive patients with subfoveal neovascularization due to AMD. The follow-up was at least 6 months. Main outcome criteria were final best corrected visual acuity and the gain in visual acuity. RESULTS: A total of 29 eyes were treated with PDT with verteporfin, and 36 underwent MT with chorioscleral infolding. Both groups were similar for age, refraction, and lesion size. The initial visual acuity was lower in the MT group than in the PDT group (20/200 versus 20/100). Mean follow-up was 11 months for the PDT group and 14 months for the MT group. The mean displacement of the fovea after translocation was 1,274 microm (range, 250 to 1,900 microm). Mean number of retreatment by PDT was 2.5. At 1 year, both groups had the same final visual acuity (20/200), but the improvement was more favorable in the MT group (gain of 0.7 line in the MT group versus loss of 3.4 lines in the PDT group, P =.007). One eye in the PDT group (4.3%) had a gain of 3 lines or more versus eight eyes (38%) in the MT group; the lesion size was larger in the PDT group than in MT group (P =.036). CONCLUSION: In this retrospective study, MT seemed to allow a better preservation of visual acuity than PDT in subfoveal neovascularization due to AMD. Further larger and controlled studies are required.