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


METHODS
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.


CONCLUSIONS
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.
Ahlswede
W
W
Augenklinik, Universitätsklinikum Schleswig-Holstein, Lübeck.
Michels
S
S
Birngruber
R
R
Schmidt-Erfurth
U
U
D020256:Choroidal Neovascularization / Q000175:diagnosis* / Q000188:drug therapy; D005451:Fluorescein Angiography; D005500:Follow-Up Studies; D006414:Hematoporphyrin Photoradiation; D006801:Humans; D007091:Image Processing, Computer-Assisted; D021621:Imaging, Three-Dimensional; D008268:Macular Degeneration / Q000175:diagnosis* / Q000188:drug therapy; D011166:Porphyrins / Q000008:administration & dosage; D016896:Treatment Outcome; D000077362:Verteporfin
D011166:Porphyrins; D000077362:Verteporfin