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JC Chen, JA Marinier, H Kergoat, JV Lovasik, MG Quigley; Choroidal Blood Flow in Verteporfin Treatment of Age Related Macular Degeneration . Invest. Ophthalmol. Vis. Sci. 2002;43(13):586.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose:The clinical goal of Photodynamic Therapy (PDT) is to retard or arrest the deterioration of vision in exudative age related macular degeneration (ARMD). It involves an injection of a light-sensitive dye (e.g. verteporfin) which targets the aberrant neovascular membrane (NVM). When the dye-NVM complex is briefly exposed to a 689 nm light beam, the aberrant vessels are preferentially coagulated for the purpose of improving or stabilizing vision. This procedure is repeated every 3-4 months because leaky sub-retinal vessels are reformed. The purpose of the present study was to determine whether PDT has some yet unknown effects on the choroidal blood flow (ChBF). Here we looked for effects on the pulsatile ocular blood flow (POBF) originating from the choroid because with each treatment, some vaso-active substance may be released to alter normal ChBF. Methods:Fourteen adults (mean age: 76.5 ± 6.1 yrs) with wet ARMD and a NVM volunteered for this study. The POBF was measured twice with a UK OBF tonometer about 10 minutes before and after PDT. The choroidal pulse amplitude (PA) was also analyzed to derive some index of any changes in blood flow facility. Subjects remained seated during all testing. Results:For this cohort of subjects a paired t-test indicated that both the POBF and the PA measured before (POBF: 705.5 ± 57.5 µl/min; PA: 2.23 ± 0.21 mmHg) and after (731.6 ± 62.3 µl/min; PA: 2.27 ± 0.17 mmHg) PDT did not differ statistically (p≷0.05). No adverse effects were manifest during treatment and testing. Conclusion:Our data indicated that the global ChBF remained undisturbed shortly after PDT treatment targeted at aberrant sub-foveal vessels. This observation was clinically reassuring for continuing treatments of ARMD by PDT. Further studies are needed to evaluate the predictive value of POBF for long-term outcomes in ARMD management.
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