Fundus Autofluorescence in Age-Related Macular Degeneration and Type 2 Choroidal Neovascularization Before and After Photodynamic Therapy With Verteporfin

Abstract

Purpose:: To elucidate the distribution of fundus autofluorescence (FAF) before and after photodynamic therapy (PDT) with verteporfin in patients with type 2 choroidal neovascularization (CNV) of age-related macular degeneration (AMD).

Methods:: Nine eyes of 9 patients were followed by FAF images for more than 3 months after PDT. FAF images were obtained using a fundus camera-based systememploying a banpass filter for the excitation light centered at 580nm and a matched barrier filter centered at 695 nm. ( Topcon TRC-50X fundus camera )

Results:: Before PDT, seven eyes of the 9 eyes showed ring-shaped hyperfluorescence (R-shaped FAF) with unclear margins at the CNV sites. Two eyes of the 7 eyes had developed the R-shaped FAF at the previously non-hyperflurescent CNV sites during the follow-up period before PDT. The rest of the two eyes remained showing no hyperfluorescence at the CNV sites before PDT. One month after PDT, the unclear margins of the R-shaped FAF became clear in the seven eyes, in five of which the margins returned to be unclear by the follow-up examination 3 months after PDT. The remaining two eyes previously showing no hyperfluorescence at the CNV sites developed the R-shaped FAF within three months after PDT, with clear margins in one eye and with unclear margins in another eye. The 6 eyes with unclear margins of the R-shaped FAF and one eye with the clear margins had an additional session of PDT 3 months after the initial PDT.

Conclusions:: The R-shaped FAF changed during the follw-up periods before and after PDT, and the R-shaped FAF with unclear margins appeared in the active stage of CNV, probably associated with disorders of outer photoreceptor segments and retinal pigment epithelium. Evaluation of FAF may be one useful noninvasive method to evaluate the activity of CNV.

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