Photodynamic Therapy for Choroidal Neovascularization in Pediatric Patients

Giansanti, Fabrizio; Virgili, Gianni; Varano, Monica; Tedeschi, Massimiliano; Rapizzi, Emilio; Giacomelli, Giovanni; Menchini, Ugo

doi:10.1097/00006982-200507000-00009

Cited by 38 publications

(35 citation statements)

References 7 publications

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“…Giansanti et al [51] presented PDT for idiopathic CNV (n = 2) and CNV secondary to macular toxoplasmic scar (n = 3) in 5 pediatric patients (age range 7–15 years). Follow-up ranged from 12 to 18 months.…”

Section: Other Pdt Applications In Ophthalmologymentioning

confidence: 99%

Ocular Photodynamic Therapy – Standard Applications and New Indications (Part 2)

et al. 2007

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Photodynamic therapy (PDT) has become a well-established treatment for vascular forms of age-related macular degeneration (AMD). The implementation of evidence-based medicine principles into the treatment regimen of AMD seems to be immensly important, since AMD continues to be the most frequent cause of blindness among patients older than 65 years in industrialized countries. Numerous randomized prospective studies demonstrated high levels of evidence for the efficacy of various treatment approaches such as laser photocoagulation, PDT, subretinal surgery or novel anti-angiogenic drugs [Arch Ophthalmol 2006;124:597–599]. The high evidence shown by these studies supported the rationale to use PDT also in additional, less frequent, vasoproliferative diseases. Although these ‘case series’ and ‘individual case control studies’ have a low level of evidence, they give us important information for treatment decisions in these rare conditions. The goal of this survey is to review the current literature regarding PDT in vasoproliferative and exudative ocular diseases outside AMD. Many studies modified the treatment parameters of PDT to address the specific pathology of the underlying disease. Table 1 summarizes the diseases and treatment parameters that are described in this part 2, the entire table of this review is included in part 1 (www.karger.com/doi/10.1159/ 000101922).

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Section: Other Pdt Applications In Ophthalmologymentioning

confidence: 99%

Ocular Photodynamic Therapy – Standard Applications and New Indications (Part 2)

et al. 2007

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“…15,17,[27][28][29][30] Presumed ocular histoplasmosis syndrome POHS has been reported to be the most common cause of inflammatory CNV in children and adolescents. 12,13,17 POHS shows a geographical predilection and, conventionally, has been noted to occur exclusively in the United States, with no significant numbers reported in any of the other regions.…”

Section: Choroidal Neovascularization In Children and Adolescents P Rmentioning

confidence: 99%

“…30,74,75 For subfoveal CNV, alternative treatment included surgical removal of CNV 16,40,45 and transpupillary thermotherapy (TTT). For peripapillary CNV in children, good results of surgery, 64 laser photocoagulation, 70 and PDT have been reported.…”

Section: Historic Treatmentsmentioning

confidence: 99%

Choroidal neovascularization in 36 eyes of children and adolescents

Rishi

Gupta

Rishi

et al. 2013

Eye

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Purpose To describe the clinical features and outcomes among eyes with choroidal neovascularization (CNV) in children and adolescents. Methods A total of 36 eyes of 27 patients o18 years of age diagnosed with CNV between January 1978 and December 2008 were retrospectively reviewed. CNV was clinically diagnosed in all patients and its presence was confirmed by fundus fluorescein angiography (FFA). A total of 19 eyes underwent treatment. Anatomical outcome was evaluated as regressed/ persistent/recurrent CNV. Snellen's values for best corrected visual acuity (BCVA) were converted to logMAR for statistical calculations. Results Of the 27 patients, 17 (63%) were male. Nine (33.3%) of the 27 patients had bilateral CNV. At presentation, CNV was active in 22 (61.1%) eyes and regressed in 14 (28.9%) eyes. All active CNV cases were 'classic' type, with the majority (80.5%) being subfoveal. The mean greatest linear dimension (GLD) was 3.16 ± 1.94 mm (range, 0.9-10.15). The most common cause (41.7%) was post-inflammatory. The mean duration to regression in treated eyes was 103.53 days (15 eyes). Recurrence was noted in three (8.3%) eyes. The mean duration to first recurrence was 260 days (range, 90-390), and the mean follow-up duration was 779.53 ± 988.00 days. Conclusion CNV remains a cause of significant visual decline in children and adolescents. Male predominance, postinflammatory etiology, bilateral affection, and subfoveal location are noteworthy, with a high regression rate in response to treatment. Re-treatment is required in a limited number of cases.

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“…3 Patients with subfoveal ICNV are also less likely to have profound visual loss, but with significant variation between individuals, the natural course of subfoveal ICNV is difficult to predict. 4 Information on subfoveal ICNV is limited by the relatively small number of patients who fall into this subgroup.…”

Section: Introductionmentioning

confidence: 99%

“…7 Several case series reports of VPDT in patients with subfoveal ICNV have found it a safe treatment option preferable to either observation or submacular surgery. 3,[8][9][10][11] Photodynamic therapy is a two-stage treatment designed to occlude the abnormal blood vessels found in CNV while sparing overlying retinal tissue. Verteporfin (Visudyne), a photosensitizing agent, is administered intravenously and activated 15 min later by application of non-thermal red or near-infrared light at a wavelength of 689 nm.…”

Section: Introductionmentioning

confidence: 99%

Photodynamic therapy of idiopathic subfoveal choroidal neovascularization in Taiwanese patients: a 2-year follow-up

Lin

Tseng

et al. 2008

Eye

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Aims: To study the efficacy of verteporfin photodynamic therapy (VPDT) retrospectively in the treatment of idiopathic subfoveal choroidal neovascularization (ICNV) in an Asian population in correlation with number of treatments and age at treatment. This is the first report to compare the efficacy between single and multiple treatments. Results: The 28 patients receiving a single VPDT treatment showed significant improvement in VA at 3-month follow-up. The 17 patients, who did not show improvement after the first treatment, received multiple VPDT treatments. Those patients showed an even clearer trend in VA improvement although significance was detected only at the 24th month. All patients showed a significant improvement in mean VA of 0.46 logMAR (Po0.01 compared to baseline) by the end of the 24-month observation period, although VPDT treatment for subfoveal ICNV appears to stabilize vision more rapidly in younger patients. Conclusions: ICNV patients who did not benefit from single VPDT treatments could receive multiple treatments, and showed a more significant improvement in visual acuity. These results are the first of their kind in ICNV treatment.

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Photodynamic Therapy for Choroidal Neovascularization in Pediatric Patients

Abstract: PDT was safe for pediatric patients, and visual acuity was substantially stable after one or few treatments. Further follow-up is needed to assess if retinal pigment epithelium atrophic changes around the regressed CNV, possibly related to PDT, could affect vision in the long term.

Cited by 38 publications

References 7 publications

Ocular Photodynamic Therapy – Standard Applications and New Indications (Part 2)

Ocular Photodynamic Therapy – Standard Applications and New Indications (Part 2)

Choroidal neovascularization in 36 eyes of children and adolescents

Photodynamic therapy of idiopathic subfoveal choroidal neovascularization in Taiwanese patients: a 2-year follow-up

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