Photodynamic therapy for bilateral and simultaneous choroidal neovascularization in stargardt disease.

BACKGROUND: Stargardt disease may lead to chronic destructive changes to the retinal pigment epithelium and secondarily cause a lesion in the Bruch membrane, predisposing to subsequent subretinal choroidal neovascularization (CNV). METHODS: The authors report an angiographically documented, bilateral, and simultaneous case of CNV in Stargardt disease that was successfully treated with photodynamic therapy (PDT). RESULTS: A 53-year-old man with unequivocal Stargardt disease presented with CNV in both eyes simultaneously. Best-corrected visual acuity was 20/30 in the right eye and 20/40 in the left eye. PDT was performed in both eyes and vision improved to 20/25 in the right eye and 20/30 in the left eye. The lesions recurred 3 months later when vision had decreased to 20/40 in the right eye and 20/60 in the left eye. Retreatment with PDT was performed in both eyes and vision improved to 20/30 in the right eye and 20/50 in the left eye. No further recurrence was observed for 4 months. CONCLUSION: Considering the positive short-term outcome in this case as well as the limited data available, PDT may be considered in cases of CNV in Stargardt disease.