Abstract
Abstract: :
Purpose: To identify early vascular changes in classic and occult choroidal neovascularization (CNV) and in adjacent choriocapillary (CC), after photodynamic therapy (PDT). Methods: 40 patients with CNV due to age–related macular degeneration (20 classic, 7 occult, 4 retinal angiomatous proliferation – RAP), pathologic myopia (7), and inflammatory disease (2) were treated with Verteporfin PDT. Confocal scanning laser ophthalmoscope (Heidelberg Retinal Angiograph, Heidelberg Engineering GmbH, Dossenheim, Germany) was used to perform indocyanine green angiography (ICGA) before treatment and at 1 hour post PDT. Results: Immediate occlusion was achieved only in two of the RAP lesions. The significant ICGA features included leakage and hypofluorescence at early and late phases. In 22 of the 40 CNV patients, immediate massive exudation from the CNV (as opposed to the surrounding choriocapillaris) was evident one hour post PDT. In the occult and myopic CNVs, when exudation was present, it was less than that visible in the classic CNVs. Fibrosis in the CNV is correlated with less leakage. Conclusions:Results suggest that vascular structural integrity in the classic CNV was disrupted. The difference we found in the occult and myopic CNV could be related to a different structural and location characteristics of the CNV. These data do not give any information regarding the CC status immediately post PDT.
Keywords: age–related macular degeneration • photodynamic therapy • imaging/image analysis: clinical