Photodynamic therapy for choroidal neovascularization secondary to choroidal nevi

Abstract

Abstract Purpose To assess the efficacy and the safety of photodynamic therapy (PDT) for treatment of choroidal neovascularization linked to choroidal nevi. Methods It is a retrospective study including choroidal neovascularization secondary to choroidal nevi treated by PDT for 1999 to 2005. PDT was performed according to the standard protocol used for treating choroidal neovascularization secondary to age‐related macular degeneration (ARMD). Post‐PDT follow‐up was also done according to the guidelines used in ARMD. Moreover, tumors were controlled every 3 months. Results Six choroidal neovascularizations secondary to choroidal nevi were included in our study. All nevi were localized in the posterior choroids. The median of their largest diameter was of 3mm and their thickness was <2mm in all cases. Neovascular membranes were “classic” in all cases, subfoveal in 2 cases, juxtafoveal in 3 cases and extrafoveal in 1 case. The sizes of choroidal neovascularization were ≤ 1‐disk‐diameter in half the cases. On average 3.3 sessions of PDT were necessary to obtain the stabilization of choroidal neoascularization. The mean follow‐up was 35 months without any patient lost of follow‐up. Visual outcomes were extremely variable. Large or retrofoveal choroidal neovascularization but also antecedents of atrophic ARMD were related with worse functional results. No growth of the nevi was observed. Conclusion Choroidal neovascularization is considered to be a relative indicator of benignity of the naevus. However, it often marks a definitive turning point in the visual function. PDT appears as a safe and efficient procedure for treating choroidal neovascularization secondary to choroidal naevus with results similar to those observed in ARMD.