Choroidal hypoperfusion associated with photodynamic therapy for choroidal neovascularization / 中华实验眼科杂志

Choroidal neovascularization (CNV) ithe leading cause of vision disordecaused by variouretinal diseases.Apresent,many therapeutimethodare employed clinically,such aphotodynamitherapy (PDT),anti-vasculaendothelial growth facto(anti-VEGF) and transpupillary thermotherapy (TTT).However,none of them can cure CNV thoroughly and repeated treatmenirequired usually.The reason forecurrenCNV istill unclear.Choroidal hypoperfusion associated with Pdmay be one of the reasons.The purpose of thireview ito discusthe problem of choroidal hypoperfusion associated with PDfoCNV awell aitimpacon the eye and possible solutions.Thipapepresentevidenceof choroidal hypoperfusion aftePDand itrelationship with clinical outcomes.Meanwhile,the effecof combination therapy iassessed.Finally,low-fluence Pdirecommended apotential method to reduce choroidal hypoperfusion.

Changes of Choroidal Perfusion in Indocyanine Green Angiography After Photodynamic Therapy for Choroidal Neovascularization

PURPOSE: To evaluate the changes of choroidal perfusion after photodynamic therapy (PDT) documented by indocyanine green angiography (ICGA) and in pretreatment and posttreatment variables in patients with choroidal neovascularization (CNV) of age-related macular degeneration (AMD) and myopia (M). METHODS: Eight eyes (seven patients) with CNV in M (Group 1) and 30 eyes (29 patients) with CNV in AMD (Group 2) were included among 38 eyes (36 patients) that underwent PDT. ICGA, fluorescein angiography, optical coherence tomography (OCT) for central foveal thickness were conducted. Changes of choroidal perfusion were graded on a five point scales based on the degree of choridal hypoperfusion in the early and late phases of ICGA. RESULTS: Choriocapillary hypoperfusion was seen in 10 eyes among 30 eyes (33.3%) in group 2, but not in group 1 and the difference was statistically significant (p=0.002). However there is a limitation in confirming choroidal hypoperfusion owing to the thinning of both choriocapillaris and the RPE-Bruch's membrane complex in myopic CNV. In patients with CNV in AMD (Group 2), presence of choroidal hypoperfusion before PDT was accociated with the progression of hypoperfusion after PDT (p=0.001). CONCLUSIONS: In CNV in AMD, presence of choroidal hypoperfusion before treatment seems to play a role in progression of hypoperfusion after treatment.

Angiographic Findings of Choroidal Lesions in Serous Retinal Detachment

PURPOSE: To study the relationship between the damage of retinal pigment epithelum and the lesion of choroidal vessels in various types of the serous retinal detachment(SRD) on fluorescein angiography(FAG) and indocyanine green angiography(ICGA). METHODS: FAG and ICGA were performed 81 eyes with various types of serous retinal detachment. The series comprised central serous chorioretinopathy(CSC, 63 eyes), toxemia of pregnancy(8 eyes), and Harada's disease(10 eyes). RESULTS: All the eyes showed dye leakage through the retinal pigment epithelium(RPE) by FAG. Of sixty-three eyes with CSC, sixty eyes showed choroidal tissue staining in late phase on ICGA. Delayed filling of ICG dye in early phase was present around the site of leakage on FAG in 48 eyes with CSC. In toxemia of pregnancy and Harada's disease, all the cases showed delayed choroidal circulation and leakage from choroidal vessels on ICGA. As a common feature, ICGA showed choroidal hypoperfusion or delayed choroidal circulation and choroidal vascular hyperpermeability in the three types of SRD. CONCLUSIONS: The authors presume that they might contribute to the damage of RPE. The pathogenesis of SRD may be related to the hypothesis fact that choroidal vascular hyperpermeability probably moves fluid into the subretinal space from the choroid.