Photodynamic therapy of subfoveal choroidal neovascularization: clinical and angiographic examples

Details

Serval ID
serval:BIB_735FF61B87E9
Type
Article: article from journal or magazin.
Collection
Publications
Title
Photodynamic therapy of subfoveal choroidal neovascularization: clinical and angiographic examples
Journal
Graefe's Archive for Clinical and Experimental Ophthalmology
Author(s)
Schmidt-Erfurth  U., Miller  J., Sickenberg  M., Bunse  A., Laqua  H., Gragoudas  E., Zografos  L., Birngruber  R., van den Bergh  H., Strong  A., Manjuris  U., Fsadni  M., Lane  A. M., Piguet  B., Bressler  N. M.
ISSN
0721-832X (Print)
Publication state
Published
Issued date
05/1998
Volume
236
Number
5
Pages
365-74
Notes
Clinical Trial
Clinical Trial, Phase I
Clinical Trial, Phase II
Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't --- Old month value: May
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.
Keywords
Adult Aged Aged, 80 and over Capillary Permeability Choroid/*blood supply Female Fluorescein Angiography *Fovea Centralis Fundus Oculi Humans Lasers Male Middle Aged Neovascularization, Pathologic/*drug therapy *Photochemotherapy Photosensitizing Agents/adverse effects/*therapeutic use Pilot Projects Porphyrins/adverse effects/*therapeutic use Prospective Studies Recurrence Safety
Pubmed
Web of science
Create date
28/01/2008 14:09
Last modification date
03/03/2018 18:19
Usage data