PURPOSE: To investigate the factors that affect final vision following photodynamic therapy (PDT) for idiopathic subfoveal choroidal neovascularization (CNV). METHODS: A retrospective review of 16 patients whose eyes were diagnosed as idiopathic subfoveal CNV and were followed up for a minimum of 9 months. Statistical analysis was performed to investigate relationships between sex, age, size of the lesion, and initial vision compared to final vision. RESULTS: In the PDT group (10 eyes), the mean age of the patients was 34 years, mean size of the lesion was 1300 micrometer, mean initial vision was 20/60, and 7 of the 10 patients (70%) showed more than a two-line improvement in vision. Factors affecting final vision were sex (p=0.049), initial vision (p=0.0455), and size of the lesion (p=0.006). In the observation group (6 eyes), the mean age of the patients was 39 years, mean size of the lesion was 575 micrometer, mean initial vision was 20/32, and 5 of the 6 patients (83%) showed more than a two-line improvement in vision. CONCLUSIONS: The prognosis of idiopathic CNV was favorable as was reported in other studies. In the PDT group, statistically significant factors affecting final vision were initial vision, size of the lesion, and sex. However, since the number of patients sampled was insufficient and the average size of the lesions in the female patients was smaller, the size of the lesion seems to be the most important factor.
Visual Acuity ; Treatment Outcome ; Retrospective Studies ; *Photochemotherapy ; Middle Aged ; Male ; Humans ; Fundus Oculi ; Fovea Centralis ; Follow-Up Studies ; Fluorescein Angiography ; Female ; Choroidal Neovascularization/*drug therapy/pathology/physiopathology ; Adult

A 56-year-old Korean woman presented with decreased visual acuity of the right eye. She had a history of two photodynamic therapy treatments for choroidal neovascularization (CNV) due to angioid streaks in her left eye with central scarring and low visual acuity. She was diagnosed with subfoveal CNV due to angioid streaks in her right eye and treated with six intravitreal bevacizumab (1.25 mg / 0.05 mL) injections over one year. Best corrected visual acuity improved from 20 / 125 at baseline to 20 / 50 at the final visit. The area of CNV had changed into a fibrotic scar by the final visit, and fluorescein angiography and indocyanine green angiography revealed no evidence of leakage. Optical coherence tomography showed that central macular thickness decreased from 311 microm at baseline to 203 microm with complete resolution of subretinal and intraretinal fluid at the final visit. Intravitreal bevacizumab for CNV associated with angioid streaks prevented the progression of disease and resulted in the improvement of visual acuity after one year of follow-up in our patient.
Angiogenesis Inhibitors/*administration & dosage ; Angioid Streaks/*complications ; Antibodies, Monoclonal/*administration & dosage ; Choroidal Neovascularization/*drug therapy/*etiology/physiopathology ; Female ; Follow-Up Studies ; Humans ; Intravitreal Injections ; Macula Lutea/drug effects/pathology ; Middle Aged ; Tomography, Optical Coherence ; Visual Acuity/drug effects

PURPOSE: To investigate which spectral domain optical coherence tomography (SD-OCT) findings predict visual outcome after anti-vascular endothelial growth factor (VEGF) treatment in neovascular age-related macular degeneration (NV-AMD). METHODS: We reviewed the medical records of patients with treatment-naive NV-AMD who underwent three or more consecutive anti-VEGF injections. The patients were divided into three groups according to their changes of visual acuity (VA); improved (group I), static (group S), or worsened (group W). We assessed the incidences and values of all available SD-OCT findings of these groups, compared these findings between the three groups and compared the initial values with the post-treatment values. RESULTS: Better initial VA and longer external limiting membrane (ELM) length were associated with less change in VA after anti-VEGF treatment. The initial VA was mildly correlated with initial photoreceptor inner and outer segment junction (IS/OS) length and initial ELM length. The final VA was also mildly correlated with the final IS/OS length and the final ELM length. VA was significantly changed after anti-VEGF treatment in groups W and I. With regard to incidence, disruption of the IS/OS (IS/OS-D), disruption of the ELM (ELM-D) and ELM length differed significantly between the three groups, particularly ELM-D. The incidences of IS/OS-D and ELM-D in group I were significantly lower than those in groups S and W, and those in group S were also lower than those in group W. The ELM length in group I was significantly longer than it was in groups S and W, and the ELM length in group S was longer than that for group W. However, these three findings did not change after the anti-VEGF treatment. CONCLUSIONS: Initial IS/OS-D, ELM length and particularly ELM-D can be useful predictors of the visual outcome after anti-VEGF treatment in NV-AMD patients.
Aged ; Aged, 80 and over ; Angiogenesis Inhibitors/*therapeutic use ; Choroidal Neovascularization/*drug therapy/physiopathology ; Female ; Humans ; Intravitreal Injections ; Male ; Middle Aged ; Ranibizumab/*therapeutic use ; Retinal Photoreceptor Cell Inner Segment/pathology ; Retinal Photoreceptor Cell Outer Segment/pathology ; Tomography, Optical Coherence ; Vascular Endothelial Growth Factor A/antagonists & inhibitors ; Visual Acuity/*physiology ; Wet Macular Degeneration/*drug therapy/physiopathology

PURPOSE: To evaluate the 12-month outcome of anti-vascular endothelial growth factor (VEGF) treatment for extrafoveal polypoidal choroidal vasculopathy (PCV). METHODS: This retrospective observational study included 32 eyes of 32 patients newly diagnosed with extrafoveal PCV (polyps located more than 500 microm from the center of the fovea). Patients were treated with intravitreal ranibizumab, bevacizumab, or both. The best-corrected visual acuity (BCVA) and central foveal thickness (CFT) at diagnosis and at 12 months were compared. Eyes were divided into two groups according to the presence of submacular hemorrhage. The BCVA in each group was compared at baseline and at 12 months. RESULTS: During the 12-month study period, patients received an average of 4.0 +/- 1.1 anti-VEGF injections. The BCVA at baseline, three-month post-diagnosis, and 12-month post-diagnosis was 0.59 +/- 0.40, 0.34 +/- 0.38, and 0.38 +/- 0.38, respectively. The BCVA at 12 months was significantly better than the baseline value (p = 0.002). The CFT at baseline, three-month, and 12-month post-diagnosis was 477.1 +/- 194.2 microm, 214.5 +/- 108.8 microm, and 229.8 +/- 106.1 microm, respectively. The CFT at 12 months was significantly lower than the baseline value (p < 0.001). A significant improvement in BCVA was noted in eyes with and without submacular hemorrhage (n = 13, p = 0.032 and n = 19, p = 0.007, respectively). CONCLUSIONS: Anti-VEGF therapy was beneficial in extrafoveal PCV, regardless of the presence of submacular hemorrhage.
Aged ; Angiogenesis Inhibitors/*therapeutic use ; Bevacizumab/therapeutic use ; Choroidal Neovascularization/diagnosis/*drug therapy/physiopathology ; Female ; Fluorescein Angiography ; Fovea Centralis/pathology ; Humans ; Intravitreal Injections ; Male ; Microscopy, Confocal ; Middle Aged ; Polyps/diagnosis/*drug therapy ; Ranibizumab/therapeutic use ; Retrospective Studies ; Tomography, Optical Coherence ; Treatment Outcome ; Vascular Endothelial Growth Factor A/*antagonists & inhibitors ; Visual Acuity/drug effects/physiology