Enlargement of the Hypofluorescent Post Photodynamic Therapy Treatment Spot After a Combination of Photodynamic Therapy with an Intravitreal Injection of Bevacizumab for Retinal Angiomatous Proliferation

Overview

Journal Graefes Arch Clin Exp Ophthalmol

Specialty Ophthalmology

Date 2007 Oct 25

PMID 17957379

Citations 4

Authors

Alexandros A Rouvas

Thanos D Papakostas

Ioannis D Ladas

Ioannis Vergados

Affiliations

Soon will be listed here.

Abstract

Background: To report a case of enlargement of the post photodynamic therapy treatment (PDT) spot in a patient with retinal angiomatous proliferation (RAP) that was treated with PDT combined with an intravitreal injection of bevacizumab.

Methods: 74-year-old woman with RAP due to age-related macular degeneration was treated with one verteporfin PDT session, sequenced by a single intravitreal injection of bevacizumab (1.25 mg) after 30 minutes.

Results: The patient's visual acuity (VA) at baseline was 20/200 and is now at the 10-month follow-up visit 20/400, while the RAP has disappeared according to the indocyanine angiography (ICG) findings. The post PDT hypofluorescent treatment spot has enlarged from 1,450 microm at the day of the treatment, to 5,360 microm at the 6-week visit. The patient is now at the 10-month follow-up visit and the hypofluorescence is still persisting.

Conclusion: The simultaneous combination of PDT with bevacizumab in patients with RAP may enhance the photochemical stress in normal choroid with prolonged and magnified hypofluorescence in ICG, due to ischemia in normal choriocapillaries.

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References

Boscia F, Battaglia Parodi M, Furino C, Reibaldi M, Sborgia C . Photodynamic therapy with verteporfin for retinal angiomatous proliferation. Graefes Arch Clin Exp Ophthalmol. 2006; 244(10):1224-32. DOI: 10.1007/s00417-005-0205-2. View

van Wijngaarden P, Coster D, Williams K . Inhibitors of ocular neovascularization: promises and potential problems. JAMA. 2005; 293(12):1509-13. DOI: 10.1001/jama.293.12.1509. View

Schmidt-Erfurth U, Michels S . Changes in confocal indocyanine green angiography through two years after photodynamic therapy with verteporfin. Ophthalmology. 2003; 110(7):1306-14. DOI: 10.1016/S0161-6420(03)00452-4. View

Lazic R, Gabric N . Verteporfin therapy and intravitreal bevacizumab combined and alone in choroidal neovascularization due to age-related macular degeneration. Ophthalmology. 2007; 114(6):1179-85. DOI: 10.1016/j.ophtha.2007.03.006. View

Boscia F, Furino C, Sborgia L, Reibaldi M, Sborgia C . Photodynamic therapy for retinal angiomatous proliferations and pigment epithelium detachment. Am J Ophthalmol. 2005; 138(6):1077-9. DOI: 10.1016/j.ajo.2004.06.072. View

Yannuzzi L, Negrao S, Iida T, Carvalho C, Slakter J, Freund K . Retinal angiomatous proliferation in age-related macular degeneration. Retina. 2001; 21(5):416-34. DOI: 10.1097/00006982-200110000-00003. View

Heier J, Boyer D, Ciulla T, Ferrone P, Jumper J, Gentile R . Ranibizumab combined with verteporfin photodynamic therapy in neovascular age-related macular degeneration: year 1 results of the FOCUS Study. Arch Ophthalmol. 2006; 124(11):1532-42. DOI: 10.1001/archopht.124.11.1532. View

Kim I, Ryan A, Rohan R, Amano S, Agular S, Miller J . Constitutive expression of VEGF, VEGFR-1, and VEGFR-2 in normal eyes. Invest Ophthalmol Vis Sci. 1999; 40(9):2115-21. View

Klais C, Ober M, Freund K, Ginsburg L, Luckie A, Mauget-Faysse M . Choroidal infarction following photodynamic therapy with verteporfin. Arch Ophthalmol. 2005; 123(8):1149-53. DOI: 10.1001/archopht.123.8.1149. View

10.

Marneros A, Fan J, Yokoyama Y, Gerber H, Ferrara N, Crouch R . Vascular endothelial growth factor expression in the retinal pigment epithelium is essential for choriocapillaris development and visual function. Am J Pathol. 2005; 167(5):1451-9. PMC: 1603772. DOI: 10.1016/S0002-9440(10)61231-X. View

11.

Schmidt-Erfurth U, Michels S, Barbazetto I, Laqua H . Photodynamic effects on choroidal neovascularization and physiological choroid. Invest Ophthalmol Vis Sci. 2002; 43(3):830-41. View

12.

Saint-Geniez M, Maldonado A, DAmore P . VEGF expression and receptor activation in the choroid during development and in the adult. Invest Ophthalmol Vis Sci. 2006; 47(7):3135-42. DOI: 10.1167/iovs.05-1229. View

13.

Wick A, Wick W, Waltenberger J, Weller M, Dichgans J, Schulz J . Neuroprotection by hypoxic preconditioning requires sequential activation of vascular endothelial growth factor receptor and Akt. J Neurosci. 2002; 22(15):6401-7. PMC: 6758162. DOI: 20026672. View