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[Three-dimensional imaging of photodynamic effects and spontaneous course in choroidal neovascularization]

Author(s): Ahlswede W, Michels S, Birngruber R, Schmidt-Erfurth U

Affiliation(s): Augenklinik, Universitatsklinikum Schleswig-Holstein, Lubeck.

Publication date & source: 2004-07, Ophthalmologe., 101(7):675-81.

Publication type: Clinical Trial; Randomized Controlled Trial

PURPOSE: Photodynamic therapy (PDT) induces occlusive and regenerative effects in choroidal neovascularization (CNV) and physiological choroid. The process of vascular alteration is documented quantitatively and qualitatively by three-dimensional angiography. METHOD: In a prospective, randomized trial 30 patients with subfoveal CNV due to age-related macular degeneration (AMD) were treated with PDT or placebo. Fluorescence series with 32 tomographic images over a 4-mm depth were analyzed topographically and reproduced in a three-dimensional display. RESULTS: At initial presentation CNV lesions were documented as a well-defined prominence in all patients. In the verteporfin group CNV height continuously decreased with each interval. In the placebo group CNV slightly increased in height during the first 6 months and remained stable at about 90% of the initial prominence at long-term follow-up. After 12 months 44% of the patients in the verteporfin group developed an additional choroidal defect. CONCLUSION: Three-dimensional angiography offers a reliable documentation of CNV progression and regression during PDT. A decrease in CNV size is associated with an increase in choroidal perfusion defects.

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