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M Larsen, NC B B Taarnhøj, O Kjeka; Kinetics of Retinal Lipoprotein Precipitation and Elimination After Closure of Subretinal New Vessels . Invest. Ophthalmol. Vis. Sci. 2002;43(13):2496.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: To study the kinetics of retinal lipoprotein precipitation and elimination in relation to photodynamic therapy of subretinal new vessels. Methods: Retrospective observational study of digital red-free gray-scale fundus photography, intravenous flourescein angiography, and optical coherence tomography before and after photodynamic therapy of subfoveal new vessels secondary to age-related macular degeneration in 14 out of 41 eyes demonstrating precipitate at one or more visits using morphometric mapping of subretinal precipitate. Results: In 14 eyes in 14 patients with lipoprotein precipitate the area covered by precipitate increased from 0.54 optic disk areas (mean; range 0 - 2.61) before treatment to 0.65 disk areas (mean; range 0.01 - 3.04) after treatment (p=0.16). Eyes with a serous detachment before the initial treatment (n=10) demonstrated more treatment-related precipitation than patients who did not have a serous detachment at baseline (n=4) (p=0.034). In two eyes with a large amount of precipitate and a long follow-up detailed morphometric analysis demonstrated net elimination of precipitate from approximately 100 days after the initial treatment with uniexponential half-lifes of 43 and 32 days, respectively. Conclusion: Photodynamic therapy of a subfoveal new vessels may be associated with retinal lipoprotein precipitation, presumably because early extraction of water and salts from the subretinal fluid increases the intraretinal concentration of plasma proteins. Despite reperfusion of the subretinal vessels, macromolecular leakage appears to cease within 100 days, indicating that functional maturation of the new vessel with an associated decrease in pore size has occurred.
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