Abstract
Abstract: :
Purpose: To present results of a monocentre, open–lable, intra–individual controlled, pilot phase I/II, dose–finding study that was initiated to determine light dose parameters for photodynamic therapy (PDT) with verteporfin in the setting of occlusion of neovascularization (NV) of the iris, secondary to ischemic retinopathy in patients who did not benefit from panretinal laser photocoagulation and who might develope a neovascular glaucoma (NVG) Methods: Treatment parameters for a single application of PDT with verteporfin were chosen based on drug– and light dose regimen tested for chorioidal NV and on the results of animal studies. Two opposite quadrants were treated with two different light doses, escalating from 12.5–100 J/cm². Depending on the angiographic effect on the vessels, the next higher light doses were applied to the next group of 3 patients.Primary outcome was defined as change on hyperfluorescence in angiography. Safety variables were: change in anterior chamber flare, IOP and visual acuity. Data were assessed for 3 month. Results: 9 patients (18 quadrants) have been treated . Closure of neovascular vessels could be achieved with a light dose of 50–100 J/cm². The higher the light dose the longer persistent the effect was. Safety variables did not show signf. changes. Conclusions: PDT with verteporfin appears to be capable to occlude NV of the iris secondary to ischemic retinopathy. Whether this vessel occlusion will have an impact on the progression of the rubeosis or NVG is subject of further investigation.
Keywords: photodynamic therapy • anterior segment • clinical (human) or epidemiologic studies: risk factor assessment