Early neovascular bridging after photodynamic therapy of myopic choroidal neovascularization

Background: Photodynamic therapy is a relatively new modality for the treatment of subfoveal choroidal neovascularization (CNV). An unusual response to verteporfin therapy of myopic CNVs is reported. Methods: Out of 187 CNVs secondary to pathologic myopia treated with photodynamic therapy, three eyes manifested two separate foci of CNV before treatment. The three eyes were treated with verteporfin therapy according to the standard protocol, using a single spot of light that covered both neovascular fronds. Results: All the three eyes showed neovascular bridging of the two separate neovascular complexes 1 month after treatment. Conclusions: Eyes with multiple foci of myopic CNV may show unexpected outcomes after verteporfin therapy. Several factors, such as changes of the retinal pigment epithelium and choroidal vasculature involved in the treatment and enhanced expression of vascular endothelial growth factor, may play a role.