Short time behavior of choroidal neovascularizations (CNV) after photodynamic therapy with verteporfin (V-PDT)
F. Gelisken, W. Inhoffen, U. Schneider, M. Völker, M. A. Köksal, I. Kreissig
Introduction: Progression of subfoveal CNV can be delayed by V-PDT. Response to treatment within 10 days was examined to reveal correlations between vessel occlusion of CNV and visual function.
Patients and methods: 25 eyes with subfoveal classic CNV were treated with V-PDT (standard protocol). Baseline examinations included: best corrected visual acuity, fluorescein angiography, microperimetry (Rodenstock SLO) and OCT (Humphrey Instr.). These examinations were repeated within 8-14 days after treatment and the results were compared with those of the baseline examinations.
Results: Reduction of flurescein leakage as well as neurosensory detachment and retinal edema was detected in all 25 patients. However, there was no correlation with development of visual acuity, visual field and fixation behavior, as impairment and improvement were both observed.
Conclusions: Variability in visual acuity, visual field and fixation behavior with concurrent decrease in leakage and macular edema leads to the assumption of additional factors (other than leakage/edema) controlling the development of visual function after treatment. One of these factors may be damage to RPE induced by V-PDT, which may be variable as the condition of the RPE is also different before V-PDT. Further observations will show whether the short time behavior of retina/choroid after V-PDT is indicative of the visual outcome after 1-2 years.
University Eye Clinic, Dept. Retina and Vitreous Surgery, Schleichstr. 12, D-72076 Tuebingen, Germany