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Although photodynamic therapy (PDT) is an established treatment for choroidal neovascularization (CNV), the mechanisms are still not completely elucidated. Da mage to the retinal pigment epithelium (RPE) was observed following uncomplicate d PDT in young patients. Observational case series. Four female patients between the age of 26 and 39 years presented with visual loss because of classic CNV. I n two 39 years old females the CNV originated secondary to a small chorioretinal scar, in a 26 and a 36 year old woman the CNV was of idiopathic cause. All pa tients received standard PDT according to the Treatment of Age Related Macular Degeneration with Photodynamic Therapy (TAP) Study protocol. One to three months after an uncomplicated PDT with verteporfin, severe pigment epithelial alterati ons in the treatment area were observed. The neovascular membranes responded fav orably to the treatment and demonstrated fibrosis and resolution of leakage. Oph thalmoscopically and angiographically, atrophy of the retinal pigment epithelium was seen precisely delineating the size of the treatment spot used. Vision decl ined in two patients from 0.3 to 0.1 and 0.15 to 0.1. The two other patients dem onstrated an increase of visual acuity from 0.7 to 0.9 and from 0.4 to 0.9. The retinal pigment epithelium alterations did not resolve during follow up, but re mained unchanged in area and intensity. Characteristic retinal pigment epitheliu m alterations were observed in young female patients with small classic CNV foll owing PDT. Unusual retinal pigment epithelium damage in young female patients wi thout any associated disease might be related to a possible inherent defect in t he RPE or to the hormonal status of this specific patient population.
The photodynamic therapy (PDT) is an established treatment for choroidal neovascularization (CNV), the mechanisms are still not completely elucidated. Da mage to the retinal pigment epithelium (RPE) was observed following uncomplicated d PDT in young patients. Observational case series. Four female patients between the age of 26 and 39 years presented with visual loss because of classic CNV. I n two 39 years old females the CNV originated secondary to a small chorioretinal scar, in a 26 and a 36 year old woman the CNV was of idiopathic All pa tients received standard PDT according to the Treatment of Age Related Macular Degeneration with Photodynamic Therapy (TAP) Study protocol. One to three months after an uncomplicated PDT with verteporfin, severe pigment epithelial alterati ons in the treatment area were observed. neovascular effects and the fibrils and resolution of leakage. Oph thalmoscopically and angiographically, atrophy of the retinal pigment epithelium was seen precisely delineating the size of the treatment spot used. Vision decl ined in two patients from 0.3 to 0.1 and 0.15 to 0.1. The two other patients dem on strated an increase of visual acuity from 0.7 to 0.9 and from 0.4 to 0.9. The retinal pigment epithelium alterations did not resolve during follow up, but re mained unchanged in area and intensity. Characteristic retinal pigment epitheliu m alterations were observed in young female patients with small classic CNV foll owing PDT. Unusual retinal pigment epithelium damage in young female patients wi thout any associated disease might be related to a possible inherent defect in t he RPE or to the hormonal status of this specific patient population.