+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Changes in confocal indocyanine green angiography through two years after photodynamic therapy with verteporfin



Changes in confocal indocyanine green angiography through two years after photodynamic therapy with verteporfin



Ophthalmology 110(7): 1306-1314



To evaluate vascular changes documented by confocal indocyanine green angiography (ICGA) through 2 years after photodynamic therapy (PDT) with verteporfin of neovascular age-related macular degeneration (AMD). Single-center, 2-year, randomized, double-masked, interventional, placebo-controlled trial (subset from Treatment of AMD with PDT Study [TAP]). Sixty patients with subfoveal choroidal neovascularization (CNV) resulting from AMD. Patients were randomized in a ratio of 2:1 to a standard regimen using verteporfin therapy at a drug dose of 6 mg/m(2) body surface area and a light dose of 50 J/cm(2) or a sham treatment with placebo infusion and light exposure. Retreatments, if persistent fluorescein leakage from CNV was documented, were scheduled at 3-month intervals for up to 2 years. Confocal ICGA with tomographic sections was performed at baseline and continuously at the month 3, 6, 12, and 24 examinations using a standardized protocol. Analysis included the size of the neovascular net, the area of late hyperfluorescence, and choroidal hypofluorescence during early- and late-phase imaging. In the verteporfin-treated group, the mean size of the CNV and the mean area of late leakage consistent with active leakage or staining showed no further enlargement at month 12 and were reduced at month 24. In the placebo-treated group, new vessels grew threefold compared with baseline and exhibited persistent late hyperfluorescence resulting from leakage at 24 months. Associated choroidal hypofluorescence within the treated area was significantly increased in eyes treated with verteporfin PDT compared with the control group during the first year, persisted during all ICGA phases, and was irreversible during follow-up. Image analysis revealed choroidal hypoperfusion with choriocapillary dropout, which correlated with chorioretinal atrophy clinically. Progressive destruction of choroidal integrity by fibrosis in control eyes led to a similar extent of collateral hypofluorescence in both groups through the 24-month examination. Indocyanine green angiography is an important adjunct in the identification of vascular effects associated with verteporfin PDT. Repeated treatments effectively arrested CNV growth and reduced leakage activity. The collateral impairment of choroidal perfusion appears to influence the visual outcome of the treatment.

Please choose payment method:






(PDF emailed within 0-6 h: $19.90)

Accession: 010293309

Download citation: RISBibTeXText

PMID: 12867383

DOI: 10.1016/s0161-6420(03)00452-4


Related references

Comparison of fluorescein angiography and indocyanine green angiography after photodynamic therapy for choroidal neovascularization. IOVS 39(4): S242, 1998

Choroidal vascular remodelling in central serous chorioretinopathy after indocyanine green guided photodynamic therapy with verteporfin: a novel treatment at the primary disease level. British Journal of Ophthalmology 87(12): 1453-1458, 2003

Indocyanine green angiography: guided photodynamic therapy for polypoidal choroidal vasculopathy. American Journal of Ophthalmology 144(1): 7, 2007

Indocyanine green angiography guided photodynamic therapy of vascularized pigment epithelium detachment in amd. ARVO Annual Meeting Abstract Search & Program Planner : Abstract No 4993, 2003

Indocyanine green angiography and retinal sensitivity after photodynamic therapy of subfoveal choroidal neovascularization. Seminars in Ophthalmology 14(1): 35-44, 1999

Use of fluorescein and indocyanine green angiography in polypoidal choroidal vasculopathy patients following photodynamic therapy. Canadian Journal of Ophthalmology. Journal Canadien d'Ophtalmologie 43(6): 678-682, 2008

Indocyanine green angiography in eyes with substantially increased subretinal fluid 1 week after photodynamic therapy. Retinal Cases and Brief Reports 2(1): 12-14, 2008

Association between the efficacy of photodynamic therapy and indocyanine green angiography findings for central serous chorioretinopathy. American Journal of Ophthalmology 149(3): 441-6.E1-2, 2010

Immediate indocyanine green angiography and optical coherence tomography evaluation after photodynamic therapy for subfoveal choroidal neovascularization. Retina 23(2): 159-165, 2003

Sequenced combined intravitreal triamcinolone and indocyanine green angiography-guided photodynamic therapy for retinal angiomatous proliferation. Archives of Ophthalmology 124(4): 487-492, 2006

Indocyanine green angiography-guided photodynamic therapy for treatment of chronic central serous chorioretinopathy: a pilot study. Retina 23(3): 288-298, 2003

Confocal scanning laser fluorescein angiography and simultaneous indocyanine green angiography. Investigative Ophthalmology & Visual Science 37(3): S606, 1996

Indocyanine green angiography-guided photodynamic therapy for treatment of chronic central serous chorioretinopathy: a pilot study. 2003. Retina 32(Suppl. 1): 288-298, 2012

Effect of photodynamic therapy alone or combined with posterior subtenon triamcinolone acetonide or intravitreal bevacizumab on choroidal hypofluorescence by indocyanine green angiography. Retina 30(3): 495-502, 2010

Association between the efficacy of half-dose photodynamic therapy with indocyanine green angiography and optical coherence tomography findings in the treatment of central serous chorioretinopathy. American Journal of Ophthalmology 153(3): 474-480.E1, 2012