December 2002
Volume 43, Issue 13
Free
ARVO Annual Meeting Abstract  |   December 2002
Immediate Optical Coherence Tomography Evaluation After ThermoDynamic Therapy of Subfoveal Choroidal Neovascularization
Author Affiliations & Notes
  • DS Calucci
    Ophthalmology Federal University of Sao Paulo Sao Paulo Brazil
  • ME Farah
    Ophthalmology Federal University of Sao Paulo Sao Paulo Brazil
  • JA Cardillo
    Ophthalmology Federal University of Sao Paulo Araraquara Brazil
  • RA Costa
    Ophthalmology Federal University of Sao Paulo Araraquara Brazil
  • Footnotes
    Commercial Relationships   D.S. Calucci, None; M.E. Farah, None; J.A. Cardillo, None; R.A. Costa, None.
Investigative Ophthalmology & Visual Science December 2002, Vol.43, 4422. doi:
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      DS Calucci, ME Farah, JA Cardillo, RA Costa; Immediate Optical Coherence Tomography Evaluation After ThermoDynamic Therapy of Subfoveal Choroidal Neovascularization . Invest. Ophthalmol. Vis. Sci. 2002;43(13):4422.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Abstract: : Purpose: To evaluate the retinal and choroidal response after subfoveal choroidal neovascularization (CNV) treatment utilizing large spot, low irradiance 810-nm light and intravenous injection of small-volume, high-concentration indocyanine green (ICG) bolus, termed ThermoDynamic Therapy (TDT). Methods: A prospective, noncomparative case series. TDT was performed in forty eight eyes of 44 consecutive patients who presented with subfoveal CNV due to age related macular degeneration or inflammatory causes and prospective evaluation with optical coherence tomography (OCT) as well as fluorescein and ICG angiography was performed 1 hour, 1 week, and 1 and 3 months post treatment. Results: One hour after TDT a gradual increase of the retinal thickness in the treatment area was evidenced due to fluid extravasation arising from the neovascular complex as confirmed by ICG angiography, probably as a result of direct vascular damage of the neovascular complex. In contrast, hypo-perfusion of normal choroidal vessels occurred within the spot treatment area. At one week, partial or complete resolution of subretinal fluid associated with neovascular complex hypo-perfusion and restoration of choroidal perfusion were observed. A quiescent neovascular complex was usually identified and return of the foveal contour was maximum after 1 month of the initial treatment. Lesions with subretinal fluid or cystoid macular edema at 1 month of follow-up were more likely to need retreatment. Minimal choroidal alterations were occasionally identified 3 months following TDT. Conclusion: According to serial OCT and angiography evaluation post TDT, successful CNV regression occurred by means of both photodynamic and subthreshold thermal effects, thereby facilitating restoration of the retinal architecture and partial recovery of the visual function.

Keywords: 432 imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound) • 308 age-related macular degeneration • 346 choroid: neovascularization 
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