Abstract
Purpose: :
To elucidate the choroidal venous changes before and after photodynamic therapy (PDT) with verteporfin in patients with age–related macular degeneration (AMD).
Methods: :
Clinical courses of 10 eyes of 10 patients with occult CNV (O–type) and 7 eyes of 7 patients with predominantly classic CNV (P–type) were followed for more than 6 months by indocyanine green angiography (IA). ICG angiograms were obtained 15 images/second during dye transit phase with TOPCON movie IA camera. To detect the draining veins of the CNV, the subtraction analysis were performed on original images which were taken at intervals of 1 second, by TOPCON IMAGEnet system.
Results: :
Retreatment frequency is 0.5 in the O–type and 1.85 in the P–type for the first 6 months. At three months, decreased filling in the choriocapillaris was observed at the treated regions in all the 17 eyes and outside the regions in 6 eyes of the 17 eyes. Disappearance of CNV and/or narrowing of the drainig veins were noted in all the 10 eyes of the O–type, but in none of the P–type. After six months, similar findings of disappearance or narrowing of choroidal veins draining the CNV were seen in 3 eyes out of 7 eyes of P type after retreatment. Decreased inflow in the choroidal veins was shown by sbrtraction IA in the other 4 eyes of the 7 eyes.
Conclusions: :
Choroidal venous circulation responded differently to PDT in P–type and O–type CNVs of AMD. Evaluation of choroidal venous changes may be useful in understanding the pathological status after PDT and may help evaluate therapeutic outcomes.
Keywords: age-related macular degeneration • photodynamic therapy • imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound)