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

Abstract

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 ¼ 14) and nontreated contralateral (n ¼ 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 lm (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.

Choroidal blood flow after the first intravitreal ranibizumab injection in neovascular age‐related macular degeneration patients

“…The laser Doppler flowmetry (LDF) technique is a noninvasive and reproducible technique for the measurement of blood flow (BF) parameters through the foveola centralis, within the choriocapillaris, in healthy eyes or in eyes with different diseases, including ARMD (Riva et al 1994;Metelitsina et al 2004Metelitsina et al , 2008Grunwald et al 2005;Pournaras et al 2006;Maar et al 2009;Boltz et al 2010;Vinh Moreau-Gaudry et al 2010;Xu et al 2010;Berenberg et al 2012). As ChBF had a direct effect on the metabolism and physiology of the outer retina, the study of the potential effect of anti-VEGF therapy on the ChBF is of particular significance when used in macular degeneration.…”

Ocular blood flow assessment using continuous laser Doppler flowmetry

“…Measurements in 10 individuals provided a sensitivity of the LDF parameters of 7.5–17.5% for Vel ch , 14.5–37.8% for Vol ch and 19.2–31.6% for F ch . A study in 14 patients indicated values of 6.3% for Vel ch , 7.4% for Vol ch and 10.4% for F ch (Vinh‐Moreau‐Gaudry et al. 2009).…”