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Phase I clinical trial results of verteporfin enhanced feeder vessel therapy in subfoveal choroidal neovascularisation in age related macular degeneration
  1. I Kozak,
  2. L Cheng,
  3. D E Cochran,
  4. W R Freeman
  1. Jacobs Retina Center, University of California San Diego, Shiley Eye Center, La Jolla, CA, USA
  1. Correspondence to: Igor Kozak MD, University of California San Diego, Shiley Eye Center, 0946, 9415 Campus Point Drive, La Jolla, CA 92037, USA; ikozak{at}eyecenter.ucsd.edu

Abstract

Aims: To investigate the safety and effectiveness of extrafoveal photodynamic therapy (PDT) occlusion of feeder vessels (FVs) in patients with subfoveal choroidal neovascularisation (CNV) as a result of age related macular degeneration.

Methods: FVs were identified using dynamic fluorescein and indocyanine green angiography with scanning laser ophthalmoscope. The standard doses of verteporfin and laser wavelength were used. The light dose was escalated by increasing the duration of the light dose so the light regimen was 50 J/cm2 for patients 1 and 2; 100 J/cm2 for patients 3, 4, 5; 125 J/cm2 for patients 6 and 7; and 150 J/cm2 for patients 8 and 9. Patients were examined at weeks 1, 4, and 12.

Results: The mean improvement on EDTRS chart 3 months after treatment was an increase of 2.1 lines (p = 0.07). Closure of the FV was achieved angiographically in three eyes at various light doses, in three eyes the FV was hypoperfused, and in three eyes the vessels were were neither closed nor hypoperfused. At the last follow up all FVs were reperfused. There was no evidence of retinal damage.

Conclusion: Verteporfin enhanced FV therapy does not cause subfoveal retinal damage and may have potential to improve central vision in subfoveal CNV caused by exudative macular degeneration. It is not recommended as a monotherapy for CNV.

  • AMD, age related macular degeneration
  • CNV, choroidal neovascularisation
  • ETDRS, Early Treatment Diabetic Retinopathy Study
  • FA, fluorescein angiographic
  • FVs, feeder vessels
  • ICG, indocyanine green
  • logMAR, logarithm of the minimum angle of resolution
  • PDT, photodynamic therapy
  • SLO, scanning laser ophthalmoscope
  • VA, visual acuity
  • macular degeneration
  • photodynamic therapy
  • choroidal neovascular membrane
  • feeder vessel
  • AMD, age related macular degeneration
  • CNV, choroidal neovascularisation
  • ETDRS, Early Treatment Diabetic Retinopathy Study
  • FA, fluorescein angiographic
  • FVs, feeder vessels
  • ICG, indocyanine green
  • logMAR, logarithm of the minimum angle of resolution
  • PDT, photodynamic therapy
  • SLO, scanning laser ophthalmoscope
  • VA, visual acuity
  • macular degeneration
  • photodynamic therapy
  • choroidal neovascular membrane
  • feeder vessel

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Footnotes

  • Financial disclosure: none.

    Support: QLT Inc Vancouver donated the verteporfin used for this study.

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