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Photodynamic therapy and vitelliform lesions
Erdem Ergun1, Danielle Costa, Jason Slakter
1Department of Ophthalmology, University of Vienna Medical School, Vienna, Austria. erdem.ergun@akh-wien.ac.at
Retina (Philadelphia, Pa.)
|June 10, 2004
Summary
Photodynamic therapy (PDT) with verteporfin did not improve vision for adult-onset foveomacular vitelliform dystrophy (AOFVD) patients and may cause vision loss. Caution is advised when treating these vitelliform lesions.
Area of Science:
- Ophthalmology
- Medical therapy
Background:
- Vitelliform lesions, including those from cuticular drusen and adult-onset foveomacular vitelliform dystrophy (AOFVD), present a challenge in visual health.
- Photodynamic therapy (PDT) with verteporfin is a treatment modality under investigation for various ocular conditions.
Observation:
- This observational case series prospectively examined eight eyes of seven patients with vitelliform lesions treated with PDT.
- Patients received PDT specifically targeting the vitelliform lesions.
Findings:
- Photodynamic therapy (PDT) did not significantly alter median visual acuity in patients with vitelliform lesions (20/50 pre-PDT to 20/66 post-PDT).
- Four patients experienced a significant decrease in visual acuity post-PDT, suggesting a potential adverse effect.
- Fluorescein angiography showed minimal changes, while indocyanine green angiography indicated reduced choroidal perfusion in the treated areas.
Implications:
- PDT with verteporfin does not appear to positively influence visual outcomes for AOFVD or similar vitelliform lesions.
- There is a risk of iatrogenic vision impairment in some patients treated with PDT for these conditions.
- Accurate differentiation between vitelliform lesions and choroidal neovascular membranes is crucial, as PDT may be detrimental for the former.