Photodynamic therapy with verteporfin for retinal angiomatous proliferation associated with retinal pigment epithelium detachment

Purpose: Retinal angiomatous proliferation (RAP) is a particular form of exudative AMD characterized by poor natural history and unsatisfactory response to conventional laser photocoagulation. Aim of the study is analyze the effect of photodynamic therapy with verteporfin (PDT) in RAP associated with pigment epithelium detachment (PED).Methods: Nineteen eyes of 18 patients were reviewed. Each patient underwent an ophthalmologic examination including best–corrected visual acuity evaluation according to the protocol described for TAP study, fluorescein and indocyanine green angiography that were evaluated together to determine the lesion size. PDT was performed according to TAP parameters. At 3–month follow–up examinations, retreatment with the same regimen was applied if angiography showed fluorescein leakage.Results: After the mean follow–up of 10.4 months, the mean BCVA passed from 0,57 to 0,91 logMAR (p=0.0111). Overall, obliteration of RAP was observed in 4 eyes, persistence of leakage in 15 eyes, and tear of PED in 3 eyes. The mean number of PDT sessions was 2,2.Conclusions: The peculiar vascularization typical of the RAP does not allow a complete obliteration of the lesion, with most eyes undergoing enlargement and disciform transformation of the neovascular process. However, with a timely PDT in early cases with smaller lesions there may be potential for beneficial effect on visual acuity.