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Photodynamic therapy for choroidal neovascularization in pediatric patients
Fabrizio Giansanti1, Gianni Virgili, Monica Varano
1Eye Clinic, Department of Oto-Neuro-Ophthalmological Surgical Sciences, University of Florence, Florence, Italy. fabriziogiansanti@interfree.it
Insights
Photodynamic therapy (PDT) is safe for pediatric patients with choroidal neovascularization (CNV), maintaining stable visual acuity. Long-term effects of PDT on retinal pigment epithelium require further investigation.
Area of Science:
- Ophthalmology
- Pediatric Medicine
- Medical Technology
Background:
- Choroidal neovascularization (CNV) affects pediatric patients, necessitating safe and effective treatments.
- Photodynamic therapy (PDT) is a potential therapeutic option for managing CNV.
Observation:
- This study evaluated PDT in five pediatric patients (ages 7-15) with idiopathic CNV or CNV secondary to toxoplasmic scars.
- Follow-up ranged from 12 to 18 months, assessing visual acuity, CNV leakage, lesion size, and adverse events.
Findings:
- PDT demonstrated safety in pediatric patients, with no severe visual loss reported.
- PDT reduced CNV leakage in four patients and showed stable visual acuity post-treatment.
- Observed atrophic changes in the retinal pigment epithelium around regressed CNV did not cause visual impairment during the study period.
Implications:
- PDT appears to be a safe treatment for pediatric CNV, preserving visual acuity.
- Further long-term studies are necessary to determine if PDT-related retinal pigment epithelium changes impact vision over time.
Purpose:
To report the use of photodynamic therapy (PDT) for choroidal neovascularization (CNV) in pediatric patients.
Methods:
Five patients (age range, 7-15 years) who underwent PDT for idiopathic CNV (n = 2) or CNV secondary to macular toxoplasmic scar (n = 3) were included in this study. Follow-up ranged from 12 months to 18 months. PDT was performed according to the standard protocol. We evaluated visual acuity, fluorescein leakage from the CNV, greatest linear dimension of the lesion, and occurrence of ocular or systemic adverse events at baseline and during follow-up.
Results:
No severe or moderate visual loss occurred in all cases during follow-up. PDT reduced CNV leakage in four cases. No serious ocular or systemic adverse events were recorded. Retinal pigment epithelium atrophic changes were observed around the regressed CNV, but they did not appear to cause visual loss.
Conclusions:
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.
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