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D.C. Weinberger–Zeana, H.H. Baagil, M. Musazadeh, J.K. Huth, T. Kirschkamp, P. Walter, A.W. A. Weinberger; Near Infrared (IR) Reflectance Imaging in Exsudative Age Related Macular Degeneration (AMD) Before and After Photodynamic Therapy With Verteporfin . Invest. Ophthalmol. Vis. Sci. 2006;47(13):5696.
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Photodynamic therapy (PDT) with verteporfin is a standard procedure in exudative AMD. However, clinical success of PDT in terms of inducing a photothrombosis of the neovascular tissue varies. Near IR–reflectance imaging allows better identification of retinal and subretinal structures compared to funduscopy. In this study we investigated near IR reflectance images before and after PDT in exsudative AMD.
Patients with primarily classic choroidal neovascularisation (CNV) were included. Near IR–reflectance imaging and fluorescein angiography was performed with a confocal scanning laser ophthalmoscope (HRA classic) before the first treatment and at each follow up visit. Digital colour fundus photographs were taken with a Zeiss F 450 plus camera.
We included 42 eyes. In 23 eyes we observed at the initial visit an increased IR–reflectance in projection of the CNV, usually surrounding the CNV which funduscopically appeared to be either blood, pigment or fibrotic tissue. In 19 eyes there was no initially increased IR–reflectance. In these cases, however, after the first PDT increased IR–reflectance developed around the CNV which clinically appeared as beginning fibrosis. In 4 cases which were treated repeatedly due to disease progression, up to three concentric rings of increased IR–reflectance could be observed.
Increased IR–reflectance around CNV appears to indicate a beginning fibrosis. In smaller and clinically "fresher" membranes increased IR–reflectance developing after PDT appears to reflect the induction of a containment process. We are currently investigating if IR–reflectance imaging has a predictive value for response of CNV to PDT treatment.
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