Choroidal neovascularisation in type II membranoproliferative glomerulonephritis, photodynamic therapy as a treatment option--a case report

Abstract

Photodynamic therapy (PDT) is an established treatment in predominantly classic choroidal neovascularisation (CNV) in exudative age-related macular degeneration (AMD). Membranoproliferative glomerulonephritis (MPGN) type II leads to AMD-similar changes ("pseudo-AMD") of the fundus with CNV as a late complication. We report on a patient suffering from MPGN II and a classic CNV who was treated with PDT. A 31-year old male patient suffering from MPGN II from the age of 8 presented with visual deterioration and metamorphopsies on his left eye (VA OD 1.0, OS 0.25). Funduscopy revealed a "Pseudo"-AMD on both eyes and the left eye showed a 100 % classic CNV in fluorescein angiography (FLA). The left eye has treated with PDT. Visual acuity after PDT remained stable with 0.25 OS and metamorphopsies were reduced. 3 months later FLA showed a small residual leakage, therefore a second PDT was performed. 4 months after the 2 nd PDT the patient suffered again from metamorphopsies with a stable VA of 0.25 OS following a 3 rd PDT. Visual acuity of the left eye remained stable at 0.25 and metamorphopsies reduced due to the treatment of 3 PDT's. Even in "pseudo-AMD" in MPGN II the PDT is able to reduce leakage and stops progression consistent to the results in exudative AMD. In MPGN II associated "pseudo"-AMD with classic CNV the PDT was also successful. The origin of the CNV does not appear to play a role for the success of the PDT.