Photodynamic therapy of subfoveal choroidal neovascularization: clinical and angiographic examples

Abstract

· Background: Conventional photocoagulation of subfoveal choroidal neovascularization (CNV) is often accompanied by visual loss due to thermal damage to adjacent retinal structures. Photodynamic therapy (PDT) allows vascular occlusion by selective photochemical destruction of vascular endothelial cells only. In a pilot study we evaluated the use of PDT in CNV. · Methods: In a clinical phase I/II trial, patients with subfoveal CNV were treated with PDT. Benzoporphyrin derivative monoacid ring A (BPD) was used as sensitizer at a drug dose of 6 mg/m2 or 12 mg/m2. Irradiation was performed via a diode laser emitting at 690 nm coupled into a slit lamp. Safe and maximum tolerated light doses were defined by dose escalation from 25 to 150 J/cm2. Photodynamic effects were documented ophthalmoscopically and angiographically. · Results: Sixty-one patients received a single course of BPD-PDT. Preliminary results suggest no damage to retinal structures within the treated area clinically. Retinal perfusion was not altered, while CNV demonstrated immediate absence of fluorescein leakage in the majority of lesions subsequent to PDT. At optimized parameters (6 mg/m2 and 50 J/cm2) complete cessation of leakage from classic CNV occurred in 100% of cases at 1 week and in 50% at week 4. In 70–80% of classic CNV, leakage reappeared at week 12, but markedly less than before treatment. · Conclusion: PDT allows temporary absence of leakage from CNV with preservation of visual acuity. The long-term prognosis of CNV secondary to age-related macular degeneration treated with repeated courses of PDT is being evaluated in a phase III trial.

DOI: 10.1007/s004170050092

5 Figures and Tables

0204060'99'01'03'05'07'09'11'13'15'17
Citations per Year

312 Citations

Semantic Scholar estimates that this publication has 312 citations based on the available data.

See our FAQ for additional information.

Cite this paper

@article{SchmidtErfurth1998PhotodynamicTO, title={Photodynamic therapy of subfoveal choroidal neovascularization: clinical and angiographic examples}, author={Ursula M Schmidt-Erfurth and Joan W Miller and Michel Sickenberg and Arnd Bunse and H. Laqua and Evangelos S. Gragoudas and L{\'e}onidas Zografos and Reginald Birngruber and Hubert van den Bergh and A. W. Strong and Ulrike Manjuris and Mario G Fsadni and Ann M. Lane and Bertrand Piguet and Neil M. Bressler}, journal={Graefe's Archive for Clinical and Experimental Ophthalmology}, year={1998}, volume={236}, pages={365-374} }