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K.K. Peh, G. Cheung, Y.C. Yang; Loculated Fluid After Photodynamic Therapy: Fluorescein Angiogram and Optical Coherence Tomography Findings . Invest. Ophthalmol. Vis. Sci. 2006;47(13):360.
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© ARVO (1962-2015); The Authors (2016-present)
To report 2 cases of loculated fluid overlying inactive choroidal neovascularization (CNV), following Verteporfin Photo–Dynamic Therapy (VPDT); and associated Ocular Coherence Tomography (OCT) findings.
Ophthalmic history and stereoscopic fundus fluorescein angiograms (FA) were used to evaluate CNV activity for VPDT. When VPDT was applied, a Verteporfin (Visudyne; QLT and Ciba Vision Ophthalmics, Duluth, Georgia, USA) dose of 6 mg/m2 body surface area infused over 10 minutes. 5 minutes later, a laser light at 689 nm delivered 25 J/cm2 by application of an intensity 300 mW/cm2 over 83 seconds. When CNV was deemed quiescent, OCT (Zeiss Humphrey Instruments, CA) was performed using a 5mm length, single–line scan (horizontal).
2 patients with CNV secondary to age–related macular degeneration were treated with VPDT. Whilst disease activity was judged to be quiescent, there was persistent loculated fluid. This was demonstrated on OCT.
OCT is a useful adjunctive tool to FA in demonstrating loculated fluid collection overlying CNV, which may aid disease activity evaluation. The underlying mechanism of loculated fluid is probably due to RPE "pump–failure"; whereby the resultant increased resistance to flow conductivity across the RPE and choroid, due to the presence of CNV and fibrosis, causes persistent fluid accumulating over the lesion. Whilst persistent intra–retinal and sub–retinal fluid on OCT is becoming recognized as an indicator of CNV activity and retreatment with VPDT, these two cases highlight the entity of loculated fluid which does not require retreatment with VPDT.
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