Is there a role for PDT in a young patient with PXE and bilateral CNVM who requires intravitreal anti-VEGF injections every 4 weeks and is beginning to develop atrophy?  

I am not a fan of PDT for patients who are developing incipient atrophy. The question says anti-VEGF therapy is being given every 4 weeks, but it is not clear what agent is being used. I would try 2nd generation therapy such as faricimab, 8 mg aflibercept, or possibly brolucizumab (after discussion ...