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Macular Function after PDT in Myopic Maculopathy: Psychophysical and Electrophysiological Evaluation

¹From the Fondazione per l’Oftalmologia G. B. Bietti, Roma, Italy; and ²Ospedale Oftalmico, Roma, Italy.

PURPOSE. To evaluate the effects of photodynamic therapy (PDT) on macular function in myopic subfoveal choroidal neovascularization (CNV).

METHODS. Fourteen eyes of 14 patients (mean age, 48.1 ± 13.3 years) with myopic CNV (myopia ranging from –6.50 to –20 D) were enrolled. In each eye, at baseline and at 15 and 90 days after PDT with verteporfin, logMAR visual acuity (logarithm of the minimum angle of resolution VA), macular sensitivity by scanning laser ophthalmoscope microperimetry, and focal (central 9 x 9°) ERGs (FERGs) and pattern ERGs (PERGs) were assessed.

RESULTS. At 15 days after PDT, myopic CNV eyes showed, in relation to baseline values, a significant (ANOVA, P < 0.01) reduction in the diameter of the lesion that correlated (Pearson test, P < 0.01) with the significant (ANOVA, P < 0.01) increase in FERG and PERG amplitudes, VA, and scanning laser ophthalmoscopy (SLO) microperimetry results obtained from the central 1° to 2° of the macular area (SLO-CM). At 90 days after PDT, myopic CNV eyes showed, in comparison with baseline values, a nonsignificant (ANOVA, P > 0.01) reduction in the diameter of the lesion, a nonsignificant increase in VA and SLO-CM, and a still significant increase in FERG and PERG amplitudes.

CONCLUSIONS. In myopic CNV eyes, PDT induces an increase, though not significant, in VA and macular sensitivity. These changes may be related to a reduction in the diameter of the lesion, with an improvement in the function of both ganglionic and preganglionic elements of the macular region, as suggested by the improvement in FERG and PERG responses.

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