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

Abstract

Abstract Purpose To assess the short‐term changes in choroidal blood flow after photodynamic therapy (PDT) in patients with neovascular age‐related macular degeneration (AMD). Methods Fourteen patients with exudative AMD were included after complete ophthalmologic examination, fluorescein and indocyanine green angiography and optical coherence tomography. Subfoveal choroidal blood flow was assessed using laser Doppler flowmetry (LDF) in both treated (n=14) and nontreated controlateral (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 choroidal blood flow. 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 mm[188–367]. One hour 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 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.