Myopia induced neovascular membrane

I experienced a dark spot and wavy lines in my left eye a couple of months ago, went to a retina specialist who diagnosed it as a neovascular membrane due to severe myopia and treated it with PDT.  Since then I've noticed the spot growing, went back today and learned the blood leakage has stopped and the larger spot is due to scar tissue.  I'm confused because I thought scarring was not an outcome of PDT and in fact that PDT was to avoid the scarring that occurred when conventional laser treatment is used for this condition.  I'm also confused because I thought PDT required 4-5 visits and don't understand why leakage stopped after only one visit.

So my questions are, (1) is scarring an outcome of PDT, and (2) can someone recommend a specialist who is premier in this area - I'm in the northeast but will go anywhere.  I want to make sure I'm getting proper treatment, and I'm very worried that the scarring will continue as I feel this spot is growing weekly.

[Michael J Kutryb, MD]

Getting right to the point - ask your doctor if you are a candidate for Avastin/Lucentis injections.  You are absolutely correct that PDT should reduce chances of scarring - but with respect to neovascular membranes with macular degeneration Avastin/Lucentis are much, much more effective.  Any major university teaching hospital should have a good program eg Will's Eye Hospital, Wilmer Eye Institute, Massachusets Eye and Ear Infirmary, Schei Eye Institute - just a few excellent programs - but there are many more.  Again, why did you not get LUCENTIS or AVASTIN?  I wonder if it could have been considered off label use.  Might only be FDA approved for classic wet macular degeneration ???


MJK MD