JUL 31, 2008
Pediatric Ophth/Strabismus
The results of this prospective open-label study indicate that photodynamic therapy with verteporfin (PDT) is a safe and effective treatment in children and young adults with choroidal neovascularization (CNV) related to presumed ocular histoplasmosis syndrome (POHS) or pathological myopia. Significant vision improvements were seen among the pediatric patients and those without active uveitis.
The study's researchers treated with PDT 16 eyes of 16 consecutive patients aged 30 and younger, repeating the treatment if fluorescein angiography revealed persistent CNV leakage after three months. Vision improved by 2.7 lines in the seven pediatric patients after 2.4 PDT sessions and a mean follow-up period of 37 months, and by 2.6 lines in the 12 patients who did not have active uveitis. Of the total patient group, 81 percent retained stable vision within two lines or experienced significantly improved vision after a mean of 34 months and range of three to 85 months.
A mean of 2.2 PDT treatments sufficiently inactivated CNV lesions, except for one patient with MCP and two patients who did not follow up. The two MCP subjects, neither of whom were pediatric patients, experienced vision losses of five and 11 lines after four PDT sessions despite also receiving steroid treatment.
Pigment epithelial alteration was seen in 57 percent of the pediatric patients compared with 50 percent of all subjects in the study. The mean pigment epithelial lesion diameter increased by 40 percent among all of the subjects, but this factor did not correlate with vision changes.