Effects of photodynamic therapy on subfoveal blood flow in neovascular age-related macular degeneration patients.
OBJECTIVE
To assess the short-term changes in choroidal blood flow (ChBF) after photodynamic therapy (PDT) in patients with neovascular age-related macular degeneration (AMD).


METHODS
Fourteen patients with exudative AMD were included after a complete ophthalmological examination, fluorescein and indocyanine green angiography and optical coherence tomography. Subfoveal ChBF was assessed using laser Doppler flowmetry (LDF) in both treated (n=14) and nontreated contralateral (n=8) eyes, 1 h and 1 week after PDT. Ocular perfusion pressure was calculated.


RESULTS
The detection sensitivity of the LDF measurements at 2-min intervals before PDT in treated eyes was 7.4% for volume, 6.3% for velocity, and 10.4% for ChBF. The initial mean visual acuity was 0.68+/-0.3 logMar. Macular thickness at baseline as measured by OCT3 was at median (interquartile range), 326.5 microm (188-367). At 1 h and 7 days after PDT, a significant increase in velocity (15.8 and 24.4%, respectively) and a significant decrease in volume (11 and 17.9%, respectively) were noted in treated eyes. Choroidal blood flow and ocular perfusion pressure (OPP) remained similar during follow-up. No significant change in flow parameters was reported in untreated eyes.


CONCLUSIONS
The LDF technique provides feasible and reliable measurements of blood flow parameters before and after PDT in a selective population of patients with exudative AMD. The prognostic value of these early blood flow parameter changes also needs to be assessed.
Vinh Moreau-Gaudry
V
V
Department of Ophthalmology, University Hospital of Grenoble, Joseph Fourier University, Grenoble, France.
Geiser
M
M
Romanet
J P
JP
Hera
R
R
Millet
J Y
JY
Chiquet
C
C
D000368:Aged; D000369:Aged, 80 and over; D001783:Blood Flow Velocity / Q000502:physiology; D002829:Choroid / Q000098:blood supply*; D005260:Female; D005584:Fovea Centralis / Q000098:blood supply*; D006801:Humans; D017078:Laser-Doppler Flowmetry; D008266:Macula Lutea / Q000473:pathology; D008268:Macular Degeneration / Q000188:drug therapy* / Q000503:physiopathology*; D008297:Male; D008833:Microcirculation; D010778:Photochemotherapy; D012039:Regional Blood Flow / Q000502:physiology; D014792:Visual Acuity