Assessment of the perception of healthcare barriers and the impact of intravitreal injections on neovascular age-related macular degeneration.

AIM: To evaluate the perception of barriers in healthcare and the impact of intravitreal injections in patients with neovascular age-related macular degeneration (nAMD). METHODS: Cross-sectional study including 108 patients with nAMD in treatment with intravitreal injections. The patients answered a questionnaire with 26 questions (score from 1 to 5) divided in three sections: 1) the disease and its treatment with injections, 2) healthcare barriers and 3) new technologies. RESULTS: The mean age was 80.4 ±â€¯7.0 years and visual acuity (VA) was 75.2 ±â€¯12.4 letters. The main barriers in healthcare were long waiting times (72%), followed by other comorbidities (10%). Some 63% of patients have to wait between 3 and 5 h to attend their clinical visit. Significant anxiety due to the injections (2.8 ±â€¯1.3) was observed, being present in 71% of the cases the day before. A great fear of blindness and losing independence was observed (4.4 ±â€¯0.9 and 4.3 ±â€¯1.1), with no differences in relation to VA, age or sex (p ≥ 0.135). Moreover, 28% of the patients reported that it was quite or very difficult for them to attend the clinical visit, with 69% of the total showing great interest in having a diagnostic device at home. CONCLUSION: The nAMD and its treatment represent a significant burden on patients, among whom there is a great fear of blindness and of losing their independence, the main barrier being the long waiting time for the clinical visit.

Evaluación de la percepción de las barreras en la asistencia sanitaria y del impacto de las inyecciones intravítreas en la degeneración macular asociada a la edad neovascular / AEvaluación de la percepción de las barreras en la asistencia sanitaria y del impacto de las inyecciones intravítreas en la degeneración macular asociada a la edad neovascular

Propósito Evaluar la percepción de las barreras en la asistencia sanitaria y del impacto de las inyecciones intravítreas en los pacientes con degeneración macular asociada a la edad neovascular (DMAEn). Métodos Estudio transversal de 108 pacientes con DMAEn en tratamiento con inyecciones intravítreas mediante un cuestionario de 26 preguntas (puntuación del 1 al 5) divididas en 3 bloques: 1)enfermedad y su tratamiento con inyecciones; 2)barreras en la asistencia sanitaria, y 3)nuevas tecnologías. Resultados La edad media fue 80,4±7,0 años y la agudeza visual (AV) de 75,2±12,4 letras. Las principales barreras en la asistencia sanitaria fueron los largos tiempos de espera en consulta (72%), seguida por otras comorbilidades (10%). El 63% de los pacientes dedican entre 3 y 5h para acudir a la consulta. Se apreció una ansiedad notable debida a las inyecciones (2,8±1,3), estando presente en el 71% el día antes. Se observó un gran miedo a la ceguera y a dejar de ser independientes (4,4±0,9 y 4,3±1,1), sin existir diferencias en relación con la AV, la edad o el sexo (p≥0,135). El 28% de los pacientes refieren que les cuesta bastante o mucho la asistencia a consulta, presentando el 69% del total un gran interés en tener un aparato diagnóstico en el domicilio. Conclusiones La DMAEn y su tratamiento suponen una importante carga asistencial para los pacientes, existiendo un gran miedo a la ceguera y a perder su independencia, siendo la principal barrera el largo tiempo de espera en consulta (AU)

Aim To evaluate the perception of barriers in healthcare and the impact of intravitreal injections in patients with neovascular age-related macular degeneration (nAMD). Methods Cross-sectional study including 108 patients with nAMD in treatment with intravitreal injections. The patients answered a questionnaire with 26 questions (score from 1 to 5) divided in three sections: 1)the disease and its treatment with injections; 2)healthcare barriers, and 3)new technologies. Result The mean age was 80.4±7.0 years and visual acuity (VA) was 75.2±12.4 letters. The main barriers in healthcare were long waiting times (72%), followed by other comorbidities (10%). Some 63% of patients have to wait between 3 and 5hours to attend their clinical visit. Significant anxiety due to the injections (2.8±1.3) was observed, being present in 71% of the cases the day before. A great fear of blindness and losing independence was observed (4.4±0.9 and 4.3±1.1), with no differences in relation to VA, age or sex (P≥.135). Moreover, 28% of the patients reported that it was quite or very difficult for them to attend the clinical visit, with 69% of the total showing great interest in having a diagnostic device at home.Conclusion The nAMD and its treatment represent a significant burden on patients, among whom there is a great fear of blindness and of losing their independence, the main barrier being the long waiting time for the clinical visit (AU)

Assessment of vision-related quality of life and depression and anxiety rates in patients with neovascular age-related macular degeneration.

PURPOSE: To assess the vision-related quality of life and the depression and anxiety rates in patients with neovascular Age-Related Macular Degeneration (nAMD). METHODS: A cross-sectional study of patients with nAMD treated with intravitreal injections was performed. The patients completed two validated questionnaires: the Visual Functioning Questionnaire (VFQ-25, score from 0 to 100), and the Hospital Anxiety and Depression Scale (HADS) questionnaire. Age, gender and visual acuity (VA) in the Early Treatment Diabetic Retinopathy Study (ETDRS) scale was registered. RESULTS: Fifty-five patients with nAMD participated with a mean age of 80.9 ± 6.6 years-old (range 67-93) and a mean VA in the best eye of 73.5 ± 12.7 letters (range 44-95). The global VFQ-25 mean score was 57.4 ± 21.9 being 38.9 ± 13.2 for the general vision and 42.0 ± 19.5 for the general health. VA in the best eye was associated with the global score of the VFQ-25 scale (R = 0.608; P < .001), but no correlation was observed with general health (P = .936). In the HADS scale, 26.9% and 25.5% of patients had symptoms of depression and anxiety respectively. A negative correlation was found between the HADS and VFQ-25 scales for the general vision score (R = -0.438). CONCLUSION: This study elucidates the impact of vision impairment and the visual functioning in nAMD, describing an important rate of depression and anxiety symptoms.

Congenital retinal macrovessels: Case presentation.

We present an uncommon case of a unilateral congenital retinal macrovessel documented with retinography, perimetry, fluorescein angiography and macular optical coherence tomography. In the case presented the macrovessel crossed the horizontal meridian, between macula and optic disk. A literature review has been performed on congenital retinal macrovessels, possible structural and visual alterations they may cause and their association with other pathologies.

Evaluación de la calidad de vida y la presencia de síntomas de depresión y ansiedad en pacientes con degeneración macular asociada a la edad neovascular / Assessment of vision-related quality of life and depression and anxiety rates in patients with neovascular age-related macular degeneration

Propósito Evaluar la calidad de vida relacionada con la visión, así como la presecia de síntomas de depresión y ansiedad en los pacientes con degeneración macular asociada a la edad neovascular (DMAEn). Métodos Se realizó un estudio transversal de pacientes con DMAEn en tratamiento con inyecciones intravítreas de antiangiogénicos. Los pacientes realizaron 2 cuestionarios validados: el cuestionario de función visual (VFQ-25, cuya puntuación varía de 0 a 100) y la Escala hospitalaria de ansiedad y depresión (HADS). Se registraron la edad, el sexo y la agudeza visual (AV) en la escala Early Treatment Diabetic Retinopathy Study. Resultado Se incluyeron 55 pacientes con DMAEn con una edad de 80,9±6,6 años (rango 67 a 93) y una AV en el mejor ojo de 73,5±12,7 letras (rango 44 a 95). La puntuación global media en el VFQ-25 fue de 57,4±21,9, siendo 38,9±13,2 para la visión general y 42,0±19,5 para la salud general. La AV se correlacionó con la puntuación global de la escala VFQ-25 (R=0,608; p<0,001), pero no con la salud general (p=0,936). Mediante la escala HADS se detectó un 27,2% y un 25,5% de pacientes con síntomas de depresión y ansiedad respectivamente. Se observó una correlación negativa entre las puntuaciones del HADS y VFQ-25 para el dominio de visión general (R=–0,438). Conclusiones Este estudio muestra el impacto en la calidad de vida y función visual en los pacientes con DMAE neovascular, presentando en un porcentaje considerable de los casos síntomas de depresión y ansiedad (AU)

Purpose To assess the vision-related quality of life and the depression and anxiety rates in patients with neovascular Age-Related Macular Degeneration (nAMD). Method A cross-sectional study of patients with nAMD treated with intravitreal injections was performed. The patients completed two validated questionnaires: the Visual Functioning Questionnaire (VFQ-25, score from 0 to 100), and the Hospital Anxiety and Depression Scale (HADS) questionnaire. Age, gender and visual acuity (VA) in the Early Treatment Diabetic Retinopathy Study (ETDRS) scale was registered. Result Fifty-five patients with nAMD participated with a mean age of 80.9±6.6 years-old (range 67 to 93) and a mean VA in the best eye of 73.5±12.7 letters (range 44 to 95). The global VFQ-25 mean score was 57.4±21.9 being 38.9±13.2 for the general vision and 42.0±19.5 for the general health. VA in the best eye was associated with the global score of the VFQ-25 scale (R=.608; P<.001), but no correlation was observed with general health (P=.936). In the HADS scale, 26.9% and 25.5% of patients had symptoms of depression and anxiety respectively. A negative correlation was found between the HADS and VFQ-25 scales for the general vision score (R=–0.438). Conclusions This study elucidates the impact of vision impairment and the visual functioning in nAMD, describing an important rate of depression and anxiety symptoms (AU)

Macrovasos congénitos retinianos: presentación de un caso / Congenital retinal macrovessels: Case presentation

Presentamos un caso de macrovaso congénito retiniano estudiado mediante retinografía, campo visual, angiografía fluoresceínica y tomografía óptica de coherencia macular. El macrovaso atravesaba el meridiano horizontal, nasalmente entre papila y mácula. Además, se realiza una revisión de los macrovasos congénitos retinianos, las alteraciones visuales y estructurales que causan su asociación con otras enfermedades y su diagnóstico diferencial (AU)

We present an uncommon case of a unilateral congenital retinal macrovessel documented with retinography, perimetry, fluorescein angiography and macular optical coherence tomography. In the case presented the macrovessel crossed the horizontal meridian, between macula and optic disk. A literature review has been performed on congenital retinal macrovessels, possible structural and visual alterations they may cause and their association with other pathologies (AU)

Malformación arteriovenosa iridiana. Dos casos / Arteriovenous malformation of the iris. Two cases

CASO CLÍNICO: Paciente de 50 años que acudió a revisión rutinaria por presbicia. En la biomicroscopia destacaba una malformación vascular en sector temporal del iris del ojo izquierdo, siendo el resto de la exploración normal. La paciente fue diagnosticada de malformación arteriovenosa iridiana. Presentamos un segundo caso de características similares. DISCUSIÓN: Las malformaciones vasculares iridianas pueden ser asintomáticas, y pasar desapercibidas o producir hifemas por hemorragias espontáneas de repetición. El tratamiento debe ser individualizado e incluye desde la observación hasta la fotocoagulación con láser o la cirugía

CASE REPORT: A 50-year-old patient was seen during a regular follow up. The main complaint was decreased near-sight vision. Biomicroscopy showed a vascular malformation on the temporal sector of the iris in the left eye, diagnosed as an arteriovenous malformation. A second case of similar features is also presented. DISCUSSION: The vascular malformations of the iris may be asymptomatic and go unnoticed or cause recurrent spontaneous hyphemas. Treatment must be individualised and may range from observation to photocoagulation with laser, or even surgery

Arteriovenous malformation of the iris. Two cases. / Malformación arteriovenosa iridiana. Dos casos.

CASE REPORT: A 50-year-old patient was seen during a regular follow up. The main complaint was decreased near-sight vision. Biomicroscopy showed a vascular malformation on the temporal sector of the iris in the left eye, diagnosed as an arteriovenous malformation. A second case of similar features is also presented. DISCUSSION: The vascular malformations of the iris may be asymptomatic and go unnoticed or cause recurrent spontaneous hyphemas. Treatment must be individualised and may range from observation to photocoagulation with laser, or even surgery.

[Intravitreal ranibizumab (Lucentis®) in the treatment of choroidal neovascular membrane secondary to punctate inner choroidopathy]. / Ranibizumab (Lucentis®) intravítreo en el tratamiento de membrana neovascular coroidea secundaria a coroidopatía punctata interna.

CLINIC CASE: A 25 year old patient with high myopia diagnosed of metachronic choroidal neovascularisation in both eyes secondary to punctate inner choroidopathy leading to visual impairment and metamorphopsia. First eye was treated with four injections of ranibizumab after photodynamic therapy and the second eye only with charge dose of ranibizumab, reaching inactivity with good final visual acuity in both eyes. DISCUSSION: Ranibizumab is useful in the treatment of this illness. Prospective studies are needed to investigate the usefulness of a combination with adjuvant therapies such as photodynamic therapy.

Ranibizumab (Lucentis®) intravítreo en el tratamiento de membrana neovascular coroidea secundaria a coroidopatía punctata interna / Intravitreal ranibizumab (Lucentis®) in the treatment of choroidal

Caso clínico: Paciente de 25 años, miope magno que en dos años fue diagnosticado deneovascularización coroidea en ambos ojos de forma metacrónica, secundarias a coroidopatíapunctata interna, que provocaban pérdida de visión y metamorfopsias. El primer ojoes tratado con cuatro inyecciones de ranibizumab tras terapia fotodinámica, el segundosólo con dosis de carga de ranibizumab. Se consiguió la inactividad en ambos con buenaagudeza visual final.Discusión: El ranibizumab es útil en el tratamiento de esta patología. Se precisan estudiosprospectivos para investigar la utilidad de la asociación con terapias adyuvantes, como laterapia fotodinámica(AU)

Clinic case: A 25 year old patient with high myopia diagnosed of metachronic choroidalneovascularisation in both eyes secondary to punctate inner choroidopathy leading tovisual impairment and metamorphopsia. First eye was treated with four injections ofranibizumab after photodynamic therapy and the second eye only with charge doseof ranibizumab, reaching inactivity with good final visual acuity in both eyesDiscussion: Ranibizumab is useful in the treatment of this illness. Prospective studies areneeded to investigate the usefulness of a combination with adjuvant therapies such asphotodynamic therapy(AU)

Ocular inflammatory signs observed in a cohort of Spanish patients with Behçet disease and ocular inflammation.

PURPOSE: To study the clinical characteristics of a cohort of Spanish patients diagnosed with Behcet disease and who also presented ocular inflammation. METHODS: Thirty cases of Behçet disease were studied retrospectively. The authors studied age distribution, distribution by sex, clinical course, laterality, type of uveitis, secondary glaucoma, corneal involvement, hypopyon, iris-lens synechiae, secondary cataract, cystoid macular edema (CME), and papillitis (optic neuritis). RESULTS: Fourteen of the patients were men and 16 were women (ratio 0.875:1). The mean age of the patients was 35.24 years (+/-10.917; 21-61 years). In 23 patients, the disease course was recurrent. In 9 patients, the disease manifested unilaterally. In 5 patients showing unilateral onset, the contralateral eye became affected. In 2 of the 30 patients, uveitis exclusively affected the anterior segment. In 8 patients, uveitis was solely posterior. There was one case of intermediate uveitis. The remaining 19 patients showed panuveitis. Three had focal chorioretinitis. One had diffuse chorioretinitis. Fifteen showed signs of diffuse vasculitis. Eight patients showed focal vasculitis. CONCLUSIONS: Women were slightly more affected than men, although the authors found no significant correlation between sex and the clinical variables examined. Apart from one unexpected case of intermediate uveitis, the observations are similar to those reported for other patient series.

Short-term anatomic effect of ranibizumab for polypoidal choroidal vasculopathy.

PURPOSE: To assess the short-term anatomic effect of intravitreal ranibizumab for polypoidal choroidal vasculopathy. METHODS: All patients had undergone a full ophthalmic examination. A monthly injection of ranibizumab was performed for 3 months. Indocyanine angiography (ICG) and optical coherence tomography (OCT) were performed 1 month after the third-month ranibizumab injection. RESULTS: Polyps disappeared on ICG angiography in 9 out of 13 lesions (69.2%). Retinal thickness diminished significantly on OCT (p=0.02). In our series we noticed a significant reduction of the percentage of patients presenting with subretinal fluid (p=0.02) and pigment epithelium detachment between the initial and final visits (0.016). In addition, we noticed that BCVA increased significantly (p 0.02). CONCLUSIONS: Monthly intravitreal injection of ranibizumab for 3 months has a short-term beneficial anatomic effect.

[Photodynamic therapy in severe chronic central serous chorioretinopaty]. / Terapia fotodinámica en coriorretinopatía serosa central crónica severa.

OBJECTIVE: To determine the efficacy of Photodynamic Therapy (PDT) in chronic Central Serous Chorioretinopathy (CSC). METHODS: Patients diagnosed with chronic CSC, with clinical evidence of activity and treated with Photodynamic Therapy, are included in this report. All were assessed by a complete ophthalmological examination, including assessment of the best corrected visual acuity (BCVA) using an ETDRS chart, fluorescein and indocyanine angiography and optical coherence tomography (OCT). The main objective of the study was to determine the mean visual acuity change. RESULTS: 11 eyes of 11 patients were included in the study, which had a mean follow-up period of 11 months. The mean BCVA increased from 20/76 to 20/64. 35% of eyes improved their BCVA by 2 lines or more, 45% remained stable and 18% lost 2 lines or more. Choroidal hyperpermeability was reduced in every case. Neurosensorial retinal detachment decreased in 80% of cases. Only one eye received a second PDT treatment due to choroidal neovascularization. An increase of atrophy over the Retinal Pigment Epithelium (RPE) was observed in another patient. CONCLUSIONS: PDT can reduce the clinical signs of activity, such as choroidal hyperpermeability or neurosensorial retinal detachment, in patients affected by chronic CSC. However, the increase in visual acuity is variable, probably due to the extent of RPE damage.

Terapia fotodinámica en coriorretinopatía serosa central crónica severa / Photodynamic therapy in severe chronic central serous chorioretinopaty

Objetivo: Determinar la eficacia y seguridad de la terapia fotodinámica en coriorretinopatía serosa central crónica (CSC) Métodos: Se incluyen pacientes con formas crónicas de CSC y signos de actividad de la enfermedad tratados con terapia fotodinámica. Se lleva a cabo una exploración oftamológica completa incluyendo la medida de mejor agudeza visual corregida (MAVC) en optotipo ETDRS, angiografía con fluoresceína (AFG) y verde de indocianina (AVI) y tomografía de coherencia óptica (OCT). El objetivo primario del estudio es determinar el cambio medio en agudeza visual. Resultados: Se han incluido 11 ojos de 11 pacientes. La MAVC media ha pasado de 20/76 a 20/64. El 35% de los ojos mejoraron su MAVC en dos o más líneas, en el 45% se mantuvo estable y el 18% perdieron dos o más líneas. En todos los casos se redujo la hiperpermeabilidad coroidea y en un 80% el desprendimiento de retina neurosensorial. Todos los pacientes recibieron un solo tratamiento salvo un caso que requirió dos por la aparición de una neovascularización coroidea (NVC). En otro caso tomograse apreció incremento de la atrofia sobre el epitelio pigmentario de la retina (EPR). El seguimiento medio ha sido de 11 meses. Conclusiones: La administración de TFD en pacientes con CSC crónica mejora especialmente los signos de actividad de la enfermedad, como la hiperpermeabilidad coroidea o el desprendimiento de retina neurosensorial. La mejoría en la agudeza visual, sin embargo, no es constante, probablemente debido a la alteración en el EPR

Objective: To determine the efficacy of Photodynamic Therapy (PDT) in chronic Central Serous Chorioretinopathy (CSC). Methods: Patients diagnosed with chronic CSC, with clinical evidence of activity and treated with Photodynamic Therapy, are included in this report. All were assessed by a complete ophthalmological examination, including assessment of the best corrected visual acuity (BCVA) using an ETDRS chart, fluorescein and indocyanine angiography and optical coherence tomography (OCT). The main objective of the study was to determine the mean visual acuity change. Results: 11 eyes of 11 patients were included in the study, which had a mean follow-up period of 11 months. The mean BCVA increased from 20/76 to 20/64. 35% of eyes improved their BCVA by 2 lines or more, 45% remained stable and 18% lost 2 lines or more. Choroidal hyperpermeability was reduced in every case. Neurosensorial retinal detachment decreased in 80% of cases. Only one eye received a second PDT treatment due to choroidal neovascularization. An increase of atrophy over the Retinal Pigment Epithelium (RPE) was observed in another patient. Conclusions: PDT can reduce the clinical signs of activity, such as choroidal hyperpermeability or neurosensorial retinal detachment, in patients affected by chronic CSC. However, the increase in visual acuity is variable, probably due to the extent of RPE damage

Combined Pegaptanib sodium (Macugen) and photodynamic therapy in predominantly classic juxtafoveal choroidal neovascularisation in age related macular degeneration.

AIMS: This prospective, open label, non-comparative, observational case series evaluates 6-month results of Pegaptanib Sodium (Macugen) and Photodynamic Therapy (PDT) in predominantly classic juxtafoveal choroidal neovascularisation (CNV) in age-related macular degeneration (AMD) in seven eyes of seven patients. RESULTS: Best corrected visual acuity (BCVA) diminished with a mean of five letters. Initial area of CNV increased significantly from 1.4 mm2 to 2.7 mm2. There was a significant increase in the greatest linear dimension (GLD) from 1280.3 microm to 2065.7 microm at the 24-week follow-up. CONCLUSION: Predominantly classic juxtafoveal CNVs are highly aggressive lesions that demonstrate poor response despite combined therapy using PDT and Macugen.

Retinal angiomatous proliferation reactivation 6 months after high-dose intravitreal acetonide triamcinolone and photodynamic therapy.

PURPOSE: To describe the incidence of retinal angiomatous proliferation (RAP) reactivation after combined treatment with a high-dose intravitreal triamcinolone acetonide (IVTA) and photodynamic therapy (PDT) at 1-year follow-up. METHODS: All patients had undergone a full ophthalmic examination. High-dose IVTA (20 mg) was injected via pars plana. Four to 7 days later, PDT was delivered. RESULTS: Fourteen eyes of 13 patients were included. Eight lesions (57%) reopened and needed retreatment with combined therapy at 6 months follow-up. At 1-year follow up, the lesion was obliterated in nine cases (64.2%) and best-corrected visual acuity improved from 0.87 logMar (range, 0.7-1) to 0.79 logMar (range, 0.5-1). CONCLUSIONS: Combined therapy using high-dose IVTA and PDT is beneficial in stabilizing RAP. However, a high incidence of RAP reactivation has been observed at 6 months, even with a high-dose IVTA injection.

Terapia fotodinámica en estrías angioides / Photodynamic therapy in angioid streaks

Objetivo: Evaluar la eficacia y seguridad de la Terapia Fotodinámica (TFD) en la neovascularización coroidea (NVC) asociada a estrías angioides (EA). Métodos: Se realiza un estudio retrospectivo de ocho pacientes (once ojos) diagnosticados de EA, que presentan neovascularización subfoveal, yuxtafoveal o extrafoveal, tratada al menos una vez con TFD. Se obtiene la mejor agudeza visual corregida (MAVC), retinografía así como angiografía con fluoresceína (AFG), antes y después del tratamiento para valorar su eficacia. El seguimiento medio fue de 13,2 meses. Resultados: Diez ojos presentaban membranas subfoveales, un ojo yuxtafoveal y otro extrafoveal. Tras la TFD, la AV se mantuvo igual en dos pacientes, aumentó en un paciente y disminuyó en ocho pacientes. En cuanto a la respuesta angiográfica, nueve ojos presentaron respuesta fibrótica tras una sesión de TFD, mientras que en dos ojos persistió exudación. Hubo tres casos de recidiva de la NVC. Conclusiones: La TFD en la NVC asociada a EA no parece alterar el curso de esta enfermedad, sólo enlentece su progresión

Objetive: To evaluate the efficacy and safety of photodynamic therapy in choroidal neovascularization associated with angioid streaks. Methods: We performed a retrospective study of eleven eyes (eight patients) with subfoveal, juxtafoveal or extrafoveal neovascularization, which received at least one session of photodynamic therapy. Treatment efficacy was evaluated by visual acuity (VA) testing, color photography and fluorescein angiography. The mean follow-up was 13.2 months. Results: Ten eyes presented subfoveal neovascularization, one eye presented juxtafoveal and another eye extrafoveal neovascularization. VA was unchanged in two patients, increased in one patient, and decreased in eight patients following photodynamic therapy. Nine eyes presented conversion to a fibrotic disciform lesion, whereas leakage persisted in two eyes after one session of photodynamic therapy. Recurrence of choroidal neovascularization appeared in three eyes. Conclusions: Photodynamic therapy in choroidal neovascularization related to angioid streaks does not appear to alter the course of this disease, but it does slow its progression

[Photodynamic therapy in angioid streaks]. / Terapia fotodinámica en estrías angioides.

OBJECTIVE: To evaluate the efficacy and safety of photodynamic therapy in choroidal neovascularization associated with angioid streaks. METHODS: We performed a retrospective study of eleven eyes (eight patients) with subfoveal, juxtafoveal or extrafoveal neovascularization, which received at least one session of photodynamic therapy. Treatment efficacy was evaluated by visual acuity (VA) testing, color photography and fluorescein angiography. The mean follow-up was 13.2 months. RESULTS: Ten eyes presented subfoveal neovascularization, one eye presented juxtafoveal and another eye extrafoveal neovascularization. VA was unchanged in two patients, increased in one patient, and decreased in eight patients following photodynamic therapy. Nine eyes presented conversion to a fibrotic disciform lesion, whereas leakage persisted in two eyes after one session of photodynamic therapy. Recurrence of choroidal neovascularization appeared in three eyes. CONCLUSIONS: Photodynamic therapy in choroidal neovascularization related to angioid streaks does not appear to alter the course of this disease, but it does slow its progression.