Optical coherence tomography after photodynamic therapy for patients with pathologic myopia

Abstract

Purpose: To evaluate early changes after photodynamic therapy (PDT) for patients with subfoveal choroidal neovascularization (CNV) due to pathologic myopia by optical coherence tomography (OCT).

Methods: PDT was performed on 10 eyes of 10 patients who presented with subfoveal CNV due to pathologic myopia. OCT was used to evaluate changes 1 day, 3 days, and 7 days after therapy. Changes in intraretinal and subretinal fluid and CNV were examined on the images obtained. The retinal elevation and the height of the neurosensory retinal detachment were calculated. From these two values, the thickness of the neurosensory retina was obtained. The thickness of the neurosensory retina was measured to ascertain the intraretinal fluid change, and the height of the neurosensory retinal detachment was measured to ascertain the subretinal fluid change.

Results: The mean pretherapy retinal elevation+/-SD increased from 211+/-28 microm to 230+/-39 microm 1 day after PDT and decreased to 221+/-36 microm 3 days after therapy. At 7 days after therapy, the mean retinal elevation+/-SD was 211+/-22 microm. The retinal elevation was due to a subretinal fluid accumulation, whereas the thickness of the neurosensory retina increased only to a minor extent (range, 0-22 microm) and the foveal architecture remained unchanged. The mean pretherapy height+/-SD of the neurosensory retinal detachment was 6+/-11 microm. It was 18+/-20 microm, 12+/-12 microm, and 3+/-6 microm 1 day, 3 days, and 7 days after therapy, respectively. No change in CNV was observed during follow-up.

Conclusion: The results of our study indicate that the acute infiltration observed in patients with pathologic myopia after PDT occurs in the first day and regresses during the first week. Yet, it should be noted that, unlike in patients with age-related macular degeneration, the acute infiltration phase can be observed by OCT only to a limited extent.