Purchase this article with an account.
N. Eter, R.F. Spaide; Fluorescein Leakage From Neovascular Lesions after Photodynamic Therapy Occurs into Loculated Cystoid Spaces in the Retina . Invest. Ophthalmol. Vis. Sci. 2003;44(13):1759.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
Purpose: To investigate retinal morphology by means of optical coherence tomography (OCT) in patients having undergone photodynamic therapy (PDT) with verteporfin. Methods: Patients who had PDT 3 months previously for predominantly classic choroidal neovascularization (CNV) were evaluated with standard fluorescein angiography with late phase photographs taken at 15 minutes and OCT. The fluorescein angiograms were evaluated for staining of and leakage from the lesion and cystoid loculation of fluid in the macula. OCT examination was used to evaluate foveal thickening and for the presence of subretinal fluid and cystoid loculation of fluid in the macula. Results: The median visual acuity of the 41 eyes of the 41 patients examined was 20/200 and the mean age was 78 years (± 7.2 SD). The median number of previous PDT sessions was 2. Fluorescein staining was seen in 39 and fluorescein leakage was seen in 32 eyes. Cystoid loculation was seen 14 eyes (36.6%), all of whom had leakage during fluorescein angiography, and this association was significant (p=0.017, Fisher’s exact test). Subretinal fluid was seen during OCT in 9 patients, 8 of whom had fluorescein leakage, an association that was not statistically significant (p=.65, Fisher’s exact test). Cystoid spaces in the macula was seen in 25 patients (61%), 23 of whom had fluorescein leakage (p=.017, Fisher’s exact test). The central fovea of patients with fluorescein leakage was not thicker in a statistically significant way (p=.33, independent samples t-test), largely because the leakage did not necessarily occur under the fovea. Conclusions: Leakage of fluorescein from a neovascular lesion previously treated with PDT usually is not associated with subretinal fluid, rather it is associated with leakage into the retina from breakdown of the outer blood retinal barrier. This fluid accumulates into loculated cystoid spaces.
This PDF is available to Subscribers Only