Follow-Up of Fundus Autofluorescence in Age-Related Macular Degeneration Associated With Classic Choroidal Neovascularization After Photodynamic Therapy

Abstract

Purpose: : To elucidate the changes of distribution of fundus autofluorescence (AF) in patients with age-related macular degeneration (AMD) associated with classic choroidal neovascularization (CNV) after photodynamic therapy (PDT).

Methods: : Clinical courses of 10 eyes of 10 patients with AMD associated with classic CNV were followed for at least one year or more after the last PDT. AF images were obtained using a fundus camera-based system employing a bandpass filter for the excitation light centered at 580nm and a matched barrier filter centered at 695 nm. ( Topcon TRC-50X fundus camera )

Results: : The number of overall PDT treatments was once in five eyes, twice in three eyes, 3 times in one eye, and 4 times in one eye. Three months after the first PDT, ring-shaped hyperfluorescence (hyper-AF) was seen at and around the CNV sites of all ten eyes. The hyper-AF was seen with clear margin up to one year after the last PDT. In two eyes, hypofluorescnece (hypo-AF), which had been seen around the CNV before starting PDT, continued to be seen in the same size. Regarding the rest of eyes, the hypo-AF surrounding the hyper-AF area appeared in three eyes by 3 months and other two eyes by 6 months after the first PDT, and in remaining three eyes by 3 months after the 2nd PDT. The hypo-AF was seen inside the treated areas with PDT and remained till one year after the last PDT in all ten eyes. During the follow-up period, different hyper-AF appeared around the hypo-AF area in four of 10 eyes.

Conclusions: : Hypo-AF developed around the classic CNV site associated with regression of the CNV after PDT, suggesting the expanding damage of RPE. Evaluation of AF may help to evaluate the development of retinal atrophy around the classic CNV.

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