Objective: To study the correlative factors of damage to the retinal pigment epithelium (RPE) after photodynamic therapy (PDT) in patients with idiopathic choroidal neovascularization (CNV).
Methods: A retrospective analysis was performed in 45 eyes of 43 patients with idiopathic CNV and 27 eyes of 25 patients with pathological myopia CNV as a contrast group who were treated with standard PDT. Visual acuity, fluorescein angiography and optical coherence tomography (OCT) were taken to evaluated the RPE alterations in the treating area after PDT.
Results: Alterations of RPE with window defects in fluorescein angiography occurred in 21 of 45 eyes of idiopathic CNV after first PDT treatment and the same changes of RPE was seen in 1 eye after the second application of PDT, the incidence was 48.9%. In contrast, it occurred in only 2 eyes of pathological myopia CNV. Within the follow up period, 4 eyes of idiopathic CNV had the enlarged neovascular membrane after the therapy. Two groups had almost the same sexual ratio. Alterations of RPE occurred in 51.4% female and 40% male patients of idiopathic CNV. In contrast with pathological myopia CNV patients, idiopathic CNV patients were younger. Two cases that had the alterations of RPE in pathological myopia CNV were 37 years old and 15 years old.
Conclusions: RPE alterations were observed in patients with idiopathic CNV following PDT. This might be related to a possible over reaction of RPE to the therapy in young patients.