Pigment epithelial changes in young women treated with photodynamic therapy and limited macular translocation for classic choroidal neovascularisation.

Objectives: The objectives of this study were to report peculiar postoperative changes at the level of the retinal pigment epithelium (RPE) in young women with moderate or mild myopia and classic choroidal neovascularisation first treated unsuccessfully with photodynamic therapy (PDT) and afterwards with limited macular translocation.

Methods: Retrospective review of two young myopic women who underwent PDT for treatment of idiopathic choroidal neovascularisation. Despite PDT, visual acuity decreased progressively, and limited macular translocation was performed 2-3 months later.

Results: During limited macular translocation (LMT) surgery, creation of retinal detachment using a 39-gauge cannula induced detachment of the RPE around the injection sites. Postoperatively, rounded flattened lesions were observed in both patients at the level of retinal pigment epithelium, with alternation of hyper- and hypopigmented rings around each site of injection. These alterations did not jeopardise visual recovery (20/25 and 20/40).

Conclusions: The exceptional occurrence of pigment epithelial detachment during LMT surgery may suggest that PDT could predispose to these lesions by means of diffuse pigment epithelial changes. It encourages further studies to improve the understanding of RPE changes after PDT.