IMMEDIATE INDOCYANINE GREEN ANGIOGRAPHY AND OPTICAL COHERENCE TOMOGRAPHY EVALUATION AFTER PHOTODYNAMIC THERAPY FOR SUBFOVEAL CHOROIDAL NEOVASCULARIZATION
IMMEDIATE INDOCYANINE GREEN ANGIOGRAPHY AND OPTICAL COHERENCE TOMOGRAPHY EVALUATION AFTER PHOTODYNAMIC THERAPY FOR SUBFOVEAL CHOROIDAL NEOVASCULARIZATION
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DOI：
10.1097/00006982-200304000-00004
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发表时间：
2003-04
期刊：
影响因子：
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通讯作者：
R. Costa;M. Farah;J. Cardillo;D. Calucci;George A. Williams
中科院分区：
文献类型：
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作者：
R. Costa;M. Farah;J. Cardillo;D. Calucci;George A. Williams
目的通过连续光学相干断层扫描(OCT)和吲哚青绿血管造影术(ICGA)观察维替泊芬光动力疗法(PDT)治疗中心凹下脉络膜新生血管(CNV)后即刻视网膜和脉络膜反应，以进一步了解PDT治疗CNV的作用机制。方法本研究为前瞻性、非对比病例系列研究。对9例(9只眼)因年龄相关性黄斑变性而出现黄斑中心凹下CNV的患者行PDT检查，分别于术后1周、1个月、3个月每隔20分钟行一次OCT和ICGA检查。结果经ICGA证实，在PDT后2小时内，OCT显示治疗区视网膜增厚，原因是新生血管复合体渗出液体。术后1周，所有患者视网膜内/视网膜下积液均明显减少。ICGA显示新生血管复合体无灌注区与治疗区一定程度的脉络膜低灌注区相关。治疗1个月后，OCT的中心凹轮廓恢复最佳。术后3个月ICGA检查脉络膜再通，OCT检查视网膜内/视网膜下积液复发。结论PDT术后连续OCT和ICGA评估提示，1周后荧光素血管造影显示的初步成功的CNV无灌注是由于治疗区选择性的PDT损伤和/或脉络膜血流减少，从而减少了视网膜内/视网膜下液体，促进了视网膜结构的恢复。
Purpose To better understand the mechanisms of action of photodynamic therapy (PDT) with verteporfin for subfoveal choroidal neovascularization (CNV), the authors evaluated the retinal and choroidal response immediately after treatment with serial optical coherence tomography (OCT) and indocyanine green angiography (ICGA). Methods This study was a prospective, noncomparative case series. PDT was performed on nine eyes of nine consecutive patients who presented with subfoveal CNV due to age-related macular degeneration, and serial evaluation with OCT as well as ICGA was performed at 20-minute intervals for the first 2 hours and then at 1 week, 1 month, and 3 months. Results In the first 2 hours after PDT, OCT showed an increase in the thickness of the retina in the treatment area due to fluid leakage from the neovascular complex as confirmed by ICGA. At 1 week, marked reduction of intraretinal/subretinal fluid was observed in all patients. Neovascular complex nonperfusion by ICGA was associated with some degree of choroidal hypoperfusion in the treatment area. Return of the foveal contour by OCT was optimal after 1 month of treatment. At 3 months, choroidal reperfusion by ICGA and recurrent intraretinal/subretinal fluid by OCT were observed. Conclusions Serial OCT and ICGA evaluation after PDT suggests that the initial successful CNV nonperfusion as shown by fluorescein angiography at 1 week occurs by means of selective PDT damage to the lesion and/or reduced choroidal blood flow in the treatment area, thereby decreasing intraretinal/subretinal fluid and facilitating restoration of the retinal architecture.