Photodynamic therapy for choroidal neovascularization associated with pattern dystrophy

Purpose: To report the results of photodynamic therapy (PDT) for subfoveal choroidal neovascularization (CNV) associated with nine eyes affected by pattern dystrophy of the retinal pigment epithelium. Methods: Each patient underwent an ophthalmologic examination complete with electroretinogram, electrooculogram, fluorescein angiography, and indocyanine green angiography to define the characteristics of the CNV. PDT was administered according to the TAP protocol. Re-treatment was decided on the basis of the detection of leakage on fluorescein angiography. Results: Classic subfoveal CNV was associated with four cases of reticular dystrophy, one case of butterfly-shaped dystrophy, and one case of pattern dystrophy simulating fundus flavimaculatus. Moreover, three cases of adult-onset foveomacular vitelliform dystrophy showed occult subfoveal CNV. The mean follow-up was 15.6 ± 2.1 months. Adult-onset foveomacular vitelliform dystrophy has the worst visual outcome, passing from 20/59 to 20/640 (mean variation, - 10.7 lines), whereas the other forms of pattern dystrophy overall retain their baseline best-corrected visual acuity of 20/51 (mean variation, +0.17 lines). Conclusions: Photodynamic therapy for subfoveal CNV associated with pattern dystrophy of the retinal pigment epithelium can stabilize visual acuity, except for occult CNV associated with adult-onset foveomacular vitelliform dystrophy.