BACKGROUND: Photodynamic therapy (PDT) performed in this rare condition showed promising results according to 3 other case reports. HISTORY AND SIGNS: A 47-year-old female patient with fundus flavimaculatus developed metamorphopsia and minimal vision deterioration (20/25) in her left eye. Fluorescein angiography revealed all signs of classic choroidal neovascularisation (CNV). THERAPY AND OUTCOME: After the first PDT treatment with a spot adapted to the size of the juxtafoveal CNV (1.5 mm) and standard parameters visual acuity (VA) dropped to 20/63, more leakage and progression to subfoveal CNV was observed. 3 months after the second PDT VA was 20/80 and FA revealed persistent leakage. Given the results of the combination treatment in age-related macular degeneration and the poor outcome seen after PDT alone in this case, PDT and intravitreal injection of 4 mg triamcinolone acetonide on the same day was applied. 3, 6 and 9 months after treatment VA stabilised at 20/63 and FA showed confirmed regression of the CNV and, thus, no leakage, but scarring. CONCLUSIONS: To the best of our knowledge this is the first published report of CNV secondary to fundus flavimaculatus in which PDT alone failed to stop leakage and progression of the CNV. However therapy combined with triamcinolone acetonide was successful.
BACKGROUND: Photodynamic therapy (PDT) performed in this rare condition showed promising results according to 3 other case reports. HISTORY AND SIGNS: A 47-year-old female patient with fundus flavimaculatus developed metamorphopsia and minimal vision deterioration (20/25) in her left eye. Fluorescein angiography revealed all signs of classic choroidal neovascularisation (CNV). THERAPY AND OUTCOME: After the first PDT treatment with a spot adapted to the size of the juxtafoveal CNV (1.5 mm) and standard parameters visual acuity (VA) dropped to 20/63, more leakage and progression to subfoveal CNV was observed. 3 months after the second PDT VA was 20/80 and FA revealed persistent leakage. Given the results of the combination treatment in age-related macular degeneration and the poor outcome seen after PDT alone in this case, PDT and intravitreal injection of 4 mg triamcinolone acetonide on the same day was applied. 3, 6 and 9 months after treatment VA stabilised at 20/63 and FA showed confirmed regression of the CNV and, thus, no leakage, but scarring. CONCLUSIONS: To the best of our knowledge this is the first published report of CNV secondary to fundus flavimaculatus in which PDT alone failed to stop leakage and progression of the CNV. However therapy combined with triamcinolone acetonide was successful.