Myopia, pathologic

The efficacy of verteporfin PDT in reducing the risk of vision loss in patients with subfoveal CNV due to AMD was investigated in multicenter, double-masked, placebo-controlled, randomized trials. The Treatment of Age-Related Macular Degeneration with Photodynamic Therapy (TAP) study consisted of two identically designed trials conducted in 22 ophthalmology practices in Europe and North America and evaluated PDT for new and recurrent subfoveal CNV with some classic component (8-11). The Verteporfin in Photodynamic Therapy (VIP) study was carried out in 28 practices across Europe and North America and involved patients with only occult CNV or classic CNV with good visual acuity as well as a subset with CNV caused by pathologic myopia (12-14). 

While AMD is a major cause of CNV, other ocular conditions also result in blindness due to CNV. Phase I and II trials suggested the safety and efficacy of verteporfin PDT in 13 patients with pathologic myopia. Based on these data and early data from the TAP trial confirming the safety of the treatment, one arm of the VIP study was designed to evaluate the benefit of verteporfin PDT for subfoveal CNV due to pathologic myopia (12,14). The inclusion criteria are shown in Table 6. 

Table 6 Eligibility Criteria for the VIP-Pathologic Myopia Study...

CNV secondary to pathologic myopia (distance correction of at least -6.0 D, spherical equivalent, or less myopic than -6.0 D with retinal abnormalities consistent with pathologic myopia, such as lacquer cracks, and an axial length at least 26.5 mm CNV under the geometric center of the foveal avascular zone Area of CNV at least 50% of the area of the total neovascular lesion Greatest linear dimension of lesion <5400 pm (not including any area of prior laser photocoagulation)... 

Features of any condition other than pathologic myopia (such as large drusen or multifocal choroiditis) associated with CNV in the study eye Tear (rip) of the retinal pigment epithelium... 

Verteporfin PDT is a safe and effective treatment for subfoveal CNV due to pathologic myopia with visual benefits demonstrated through two years of follow-up. Verteporfin PDT is recommended for subfoveal CNV resulting from pathologic myopia regardless of lesion composition. 

Verteporfin in Photodynamic Therapy Study Group. Photodynamic therapy of subfoveal choroidal neovascularization in pathologic myopia with verteporfin. 1-year results of a randomized clinical trial—VIP report no. 1. Ophthalmology 2001 108 841-852. 

The ocular complications result in pathologies to the retina (diabetic retinopathy). The lens damage by osmotically induced swelling causes myopia and cataracts it has been... 

Another porphyrin-based photosensitizer, benzoporphyrin derivative monoacid A (Verteporphin, Visudyne ), has received approval for treatment of age-related macular degeneration, and a form of pathologic myopia. 

Bevacizumab has been studied in advanced carcinoid tumors [167 ], prostate cancer [168 ], high-risk corneal transplantation [169 ], diabetic retinopathy [170 , 171, 172 ], ischemic retinal diseases [173 ], refractory choroidal neovascularization secondary to uveitis [174 ], macular edema secondary to branch retinal vein occlusion [175 ], retinal angiomatous proliferation [176% choroidal neovascularization attributable to pathological myopia [177, 178], exudative age-related macular degeneration [179 ], multifocal lymphangioendothe-liomatosis with thrombocytopenia [180" ], in combination with chemotherapy for the treatment of recurrent ovarian cancer [181 j, advanced melanoma [182 ], malignant pleural mesothelioma [183 ],... 

Arias L, Planas N, Prades S, Caminal JM, Rubio M, Pujol O, Roca G. Intravitreal bevacizumab (Avastin) for choroidal neo-vascularisation secondary to pathological myopia 6-month results. Br J Ophthalmol 2008 92(8) 1035-9. 

Ikuno Y, Sayanagi K, Soga K, Sawa M, Tsujikawa M, Gomi F, Tano Y. Intravitreal bevacizumab for choroidal neovascularization attributable to pathological myopia one-year results. Am J Ophthalmol 2009 147(1) 94-lOO.elOl. 

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