Verteporfin Photodynamic Therapy Affects Physiological Circulation of Collateral Choroid in Age–Related Macular Degeneration and Polypoidal Choroidal Vasculopathy (In Japan)

Abstract

Purpose: : To evaluate the effect of a single session verteporfin photodynamic therapy (PDT) on perfusion of choroidal neovascularization (CNV) and collateral physiological choroid in Japanese patients.

Methods: : Thirty–eight eyes in 35 Japanese patients with subfoveal CNV were treated with verteporfin PDT. Indocyanine green angiography (IA), using a confocal laser scanning system, and fluorescein angiography (FA) were performed before and 1, 4 and 12 weeks after the treatment.

Results: : Twenty–four eyes were diagnosed as age–related macular degeneration (AMD) and 14 eyes were polypoidal choroidal vasculopathy. Twelve weeks after PDT, CNV lesions were significantly reduced especially in PCV (92.9%). In AMD patients, 48% of CNV lesions showed reduction in perfusion and 50% of CNV lesions continuously being perfused. FA showed hypofluorescence especially in early–phase in the entire photosensitized area 1 week after PDT. The fluorescence gradually increased in time and the treatment spots were not distinguishable in most cases 4 weeks after PDT on FA. One the other hand, IA showed persistent hypofluorescecnce of the same area throughout the late phase in 76.3% even 4 weeks after PDT. The fluorescence gradually increased in time, however, 57.9 % of treated eyes still showed collateral hypofluorescence 12 weeks after PDT.

Conclusions: : PDT was effective in Japanese patients with subfoveal CNV. IA revealed persistent hypofluorescence in collateral physiological choroid that was not detected in FA.

Keywords: age-related macular degeneration • photodynamic therapy • choroid: neovascularization