Abstract
Abstract: :
Purpose: To analyze the choroidal vessels with indocyanin green angiography (ICG) with the Scanning Laser Ophthalmoscope (SLO) ( HRA, Heidelberg, Germany) after multiple treatment sessions of photodynamic therapy (PDT) with Verteporfine (Novartis, Switzerland) for the treatment of subfoveal choroidal neovascularization (CNV) in age related macular Degeneration (AMD) Methods: Prospective survey of thirty patients with predominantly classic subfoveal CNV (TAP study criteria) who underwent 3 PDT sessions for persistent leakage on fluorescein angiography (FA). Visual acuity (VA) was measured with ETDRS charts. FA, SLO ICG follow up allowed the analysis of the choroidal perfusion and the CNV perfusion within the treated area . Results:There were 30 eyes from 11 males and 19 females patients. Their mean age was 72 years(range:59 to 88). These patients were followed for a period of 15 months or more( range:15 to 30) Most of the eyes (60%) had stabilized VA. A few eyes (5%) experienced VA improvement (2 lines) and 35% of the eyes showed a deterioration of VA of the treated eye of more than 2 lines on ETDRS .The CNV were still perfused in ICG–SLO, at least partially, in 45% of the eyes , after 3 PDT sessions, but regressed in their area in more than 80% of the eyes .These data were correlated with persistence (43%) or absence (57%) of leakage in FA respectively. Choroidal vessel perfusion changes were present in ICG in all cases, with rarefaction and more or less extensive area of non perfusion of normal choroidal vessels in 31% of the eyes . Non perfusion area of half or more of the re–treated area was observed in 38% of the eyes in ICG–SLO. Conclusions: Multiple sessions of PDT–V treatment for persistent and/or recurrent leakage of CNV were efficient for stabilizing the disease and achieving cessation of leakage. Normal choroidal vessel perfusion changes were evidenced with SLO–ICG. Exudative AMD with active classic CNV was replaced by non–exudative, flat macula but with partial non perfusion of the choroid in the treated area .
Keywords: imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound) • age–related macular degeneration • photodynamic therapy