Content area
Full Text
High myopia is an ocular disease characterised by excessive axial length, and a number of changes in the ocular tissues, affecting approximately 2% of general population 1 and 27-33% of myopic eyes. 2 A major complication and cause of decreased central vision in these eyes is macular choroidal neovascularisation (CNV), which is often followed by subretinal fibrosis (SRF), as part of the myopic maculopathy that is the most common cause of vision loss in highly myopic patients. 3
Different patterns of anatomical outcome, with variable results in terms of visual results have been described following the natural history and therapeutic approaches of myopic CNV. 3- 6
In this study we have investigated the occurrence of subsequent SRF in verteporfin photodynamic therapy (PDT) treated patients, more than a year since treatment was started.
PATIENTS AND METHODS
A total of 32 consecutive patients (33 eyes) with high myopia and subfoveal CNV were recruited from the retina unit at the Instituto Oftalmológico de Alicante, Spain, from June 2000 to February 2001. Informed consent was obtained from all patients.
Inclusion criteria for this study were similar to those previously published for the VIP-1 study and by our group in a previous report. 6, 7
The initial evaluation included refraction, best corrected visual acuity (BCVA) performed with the ETDRS charts (Lighthouse International, NY, USA), slit lamp examination, tonometry, fundus examination using indirect ophthalmoscopy and biomicroscopy, and fluorescein angiography, which was repeated on a 3 month schedule. Special attention was paid to the appearance of SRF and its relation to age, sex, size of CNV at baseline, spherical equivalent (SE), initial and final BCVA, and number of previous PDT sessions.
SRF was defined as the appearance of a whitish formation under the retina in the absence of blood or exudates which showed staining in late angiographic frames without leakage of fluorescein. 8
Eyes were also classified according to the degree of chorioretinal atrophy following Avila's classification 3 in M1-M2 (choroidal pallor, tessellation, posterior staphyloma, or lacquer cracks), and M3-M4 (small atrophic patches to large geographic areas of chorioretinal atrophy in the macula).
Verteporfin PDT was performed as described previously. 6, 7 Only when angiographic confirmation of CNV was found did patients receive further treatment with PDT, which was performed not...