Safety of photodynamic therapy involving optic nerve head

We present a case of large peripapillary polypoidal choroidal vasculopathy treated with standard-fluence photodynamic therapy (PDT) as other treatment options were unsuccessful or not justified. Due to large lesion size, treatment spot included part of optic disc also. PDT resulted in regression of polyp and visual improvement (from 20/300 to 20/20) without any collateral damage to optic nerve as evidenced by visual-field test and visual-evoked potential with a follow-up till 2 years. This case highlights the role of PDT as a safe alternative for treatment of large peripapillary lesion, even though the treatment spot encompasses part of the optic nerve head.