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Akira Obana, Yuko Gohto, Kenji Kaneda, Susumu Nakajima, Tokuhiko Miki; PDT to Monkey CNV with ATX-S10(Na): Inappropriateness of Early Laser Irradiation for Selective Occlusion. Invest. Ophthalmol. Vis. Sci. 2001;42(11):2639-2645.
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purpose. There is controversy about which mode of laser irradiation, early
irradiation with low-dose photosensitizer or late irradiation with
high-dose, benefits the selective occlusion of choroidal
neovascularization (CNV) in photodynamic therapy (PDT). In this study,
using an amphiphilic photosensitizer, 13,17-bis (1-carboxypropionyl)
porphyrin sodium (ATX-S10(Na); Photochemical Inc., Okayama, Japan),
photodynamic and adverse effects of early irradiation on CNV-bearing
monkey eyes were investigated.
methods. Experimentally induced CNV lesions and normal retina were irradiated
with a diode laser (670-nm wavelength) at a dose of 1 to 90
J/cm2 at 1 to 19 minutes after intravenous injection of 2
mg/kg body weight of ATX-S10(Na). Vascular occlusion and CNV recurrence
were evaluated by fluorescein and indocyanine green angiography and
histologic analysis, until 4 weeks after irradiation.
results. Of 45 different conditions, 23 did not induce CNV closure, 20 provided
both CNV occlusion and retinal vessel damage, and 2 achieved selective
CNV occlusion without retinal vascular injury. Recurrence of CNV was
induced in 19 of 22 CNV-occluding conditions. ATX-S10(Na) angiography
showed that dyes were similarly distributed between normal vessels and
CNV at early time periods after injection, whereas they were
preferentially accumulated in CNV after 30 minutes.
conclusions. In PDT with ATX-S10(Na), irradiation within 20 minutes of dye injection
failed to induce selective CNV occlusion, probably because there is no
significant difference in the biodistribution of dye between CNV and
retinal vessels. It also caused frequent CNV recurrence after extensive
inflammation in the irradiated retina.
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