Photodynamic therapy for bilateral and simultaneous choroidal neovascularization in stargardt disease

Stargardt disease may lead to chronic destructive changes to the retinal pigment epithelium and secondarily cause a lesion in the Bruch membrane, predisposing to subsequent subretinal choroidal neovascularization (CNV).

The authors report an angiographically documented, bilateral, and simultaneous case of CNV in Stargardt disease that was successfully treated with photodynamic therapy (PDT).

A 53-year-old man with unequivocal Stargardt disease presented with CNV in both eyes simultaneously. Best-corrected visual acuity was 20/30 in the right eye and 20/40 in the left eye. PDT was performed in both eyes and vision improved to 20/25 in the right eye and 20/30 in the left eye. The lesions recurred 3 months later when vision had decreased to 20/40 in the right eye and 20/60 in the left eye. Retreatment with PDT was performed in both eyes and vision improved to 20/30 in the right eye and 20/50 in the left eye. No further recurrence was observed for 4 months.

Considering the positive short-term outcome in this case as well as the limited data available, PDT may be considered in cases of CNV in Stargardt disease.