ABSTRACT
To evaluate the outcome of photodynamic therapy (PDT) and the factors influencing its outcome in patients with subfoveal choroidal neovascularization (CNV) due to pathologic myopia. Twenty-three eyes of 21 consecutive patients who received PDT for subfoveal CNV due to pathologic myopia and who were followed for >12 months were included in the study. The relationship between the factors that might affect the treatment outcome were evaluated. Mean age was 48.7 ± 16.0 years (23-74 years). Mean follow-up was 23.2 ± 7.7 months (15-41 months). Mean logMAR visual acuity was 0.85 ± 0.24 before treatment, 0.89 ± 0.37 at 12 months, and 0.92 ± 0.46 at the final visit. Mean logMAR visual acuity did not change significantly at 12 months or at the final visit (P = 0.47 and 0.36, respectively). The baseline visual acuity strongly correlated with the final visual acuity (P = 0.001). Age showed an inverse correlation with change in logMAR visual acuity at 12 months (P = 0.01). PDT prevented significant visual loss in eyes with subfoveal CNV due to pathologic myopia. Better initial visual acuity resulted in better final visual acuity. Younger age was correlated with better treatment outcome at 12 months.
Subject(s)
Choroidal Neovascularization/drug therapy , Myopia, Degenerative/complications , Photochemotherapy , Adult , Aged , Choroidal Neovascularization/etiology , Choroidal Neovascularization/physiopathology , Contrast Sensitivity/physiology , Female , Fluorescein Angiography , Humans , Male , Middle Aged , Myopia, Degenerative/physiopathology , Photosensitizing Agents/therapeutic use , Porphyrins/therapeutic use , Risk Factors , Tomography, Optical Coherence , Treatment Outcome , Verteporfin , Visual Acuity/physiology , Young AdultABSTRACT
PURPOSE: To evaluate the anatomic and functional outcomes of 25-gauge sutureless vitrectomy in primary treatment of noncomplex retinal detachments (RD) in pseudophakic and phakic eyes. METHODS: In this interventional clinical case series, 23 pseudophakic and 13 phakic eyes with total RDs with proliferative vitreoretinopathy grade A/B underwent primary 25-gauge sutureless vitrectomy with oblique sclerotomies and gas endotamponade. Eyes with minimum follow-up of 6 months were evaluated. Main outcome measures were single surgery and final reattachment rates, complications, and changes in visual acuity (VA). RESULTS: Mean duration of visual loss was 14.65+/-12.57 and 22.46+/-18.95 days in pseudophakic and phakic eyes, respectively. Eighteen (78.26%) pseudophakic eyes and 12 (92.30%) phakic eyes had macular detachment. In all eyes, 25-gauge sutureless vitrectomy was completed without complication. Mean follow-up period was 11.00+/-6.63 months. Single surgery and final retinal attachment rates were 91.30% and 95.65% in pseudophakic eyes and 61.53% and 84.61% in phakic eyes, respectively (p=0.073, p=0.539). In both groups, mean VA increased significantly at postoperative month 1 (p<0.05) and at the last visit (p<0.001). Transient hypotony was detected in 2 pseudophakic and 3 phakic eyes with spontaneous resolution. Two (15.38%) phakic eyes had cataractous changes. CONCLUSIONS: In this study, 25-gauge sutureless vitrectomy resulted in higher single surgery and final anatomic success rates in primary treatment of noncomplex RDs in pseudophakic versus phakic eyes, with commensurate increase in VA.
