Effects of photodynamic therapy on subfoveal blood flow in neovascular age-related macular degeneration patients.

AIM: 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. CONCLUSION: 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.

[Surgery for choroidal subfoveal neovascularization in patients with severe myopia. Retrospective analysis of 17 patients]. / Chirurgie des néovaisseaux choroïdiens rétrofovéolaires du sujet myope fort.

UNLABELLED: Treatment of choroidal neovascularization in pathological myopia is still controversial. METHODS: A retrospective analysis of 17 patients with severe myopia (>-6) and subfoveal choroidal neovascularization who underwent surgical removal of choroidal neovascularization, was performed. The patient population consisted of 2 groups: 9 patients younger than 50 years and 8 patients older than 50 years. All the patients underwent vitrectomy with surgical removal of subfoveal choroidal neovascularization. RESULTS: We reviewed the postoperative clinical and angiographic findings. In group I, visual acuity improved in 4 eyes (44%), remained unchanged in 4 eyes (44%) and decreased in one eye. In group II, none of the patients had visual improvement, visual acuity remained unchanged in 6 eyes (71%), and decreased in 2 eyes. CONCLUSION: The visual outcomes in most patients in this series were better than their natural history. Surgical removal of subfoveal choroidal neovascularization associated with severe myopia may provide visual benefit in young patients. A prospective, randomized clinical trial is necessary to determine the place of this surgical procedure.