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S. Romano, F. Mazzolani, L. Migliavacca, L. Vitale, N. Orzalesi; Early Angiographic Events in AMD Occult Neovascularization After Photodynamic Therapy . Invest. Ophthalmol. Vis. Sci. 2006;47(13):3625.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate early changes of AMD occult choroidal neovascularization (CNV) after Verteporfin Photodinamic therapy (PDT) by means of Dynamic Scanning Laser Fluorescein (FA) and Indocianine Green (ICGA) angiography.
20 eyes of 20 consecutive patients (mean age: 70 years 12 female and 8 male) affected by AMD occult CNV were enrolled in the study. ETDRS visual acuity and dynamic FA and ICGA performed with the Heidelberg Retinal Angiograph (HRA) were analyzed before and 3, 7 and 30 days after PDT. The characteristics of the ICGA hypofluorescent spot due to treatment, leakage, morphology of the neovascular net, reperfusion were considered.
The hypofluorescent spot was present in 43,75 % of patient after 2 day, in 28,13 % after 7 days and in 12,5% after 30 days. A well–defined neovascular net was evident with ICGA in 100 % of patients at baseline and was no more evident 30 days after PDT in only 12,5 % of patients. Closure of CNV correlated with the presence of hypofluorescent spot in 60% of patients after 2 days, 55 % after 7 days and 50 % of patients after 30 days. Reperfusion occurred in 37,5 % of patient after 2 days, in 62,5 % after 7 days and in 87,5% after 30 days. Leakage from the CNV was increased with respect to baseline in 37,5 % of patients after 2 days and 62,5 % and in 87,5% of patients after 7 and 30 days respectively. The mean Visual Acuity before PDT was 20/64 and remained stable throughout the follow–up in all patients.
Dynamic scanning laser ICGA is helpful to follow precisely the sub–RPE early vascular changes in occult CNV following PDT. The presence of hypofluorescent spot due to treatment does not seem to be an indicator of better effect of PDT in terms of reduced leakage, delayed reperfusion and improvement in visual acuity.
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