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Clinicopathological findings of choroidal neovascularisation following verteporfin photodynamic therapy

¹ Department of Ophthalmology I, University of Tuebingen, Germany
² Department of Ophthalmology, University of Ghent, Belgium

Correspondence to:
Correspondence to:
Dr F Gelisken
Department of Ophthalmology I, University of Tuebingen, Schleichstr. 12, 72076 Tuebingen, Germany; Faik.Gelisken{at}med.uni-tuebingen.de

ABSTRACT
Aims: To report the clinicopathologic findings of surgically excised choroidal neovascularisation (CNV) three days after verteporfin photodynamic therapy (PDT).

Methods: In three patients (three eyes) with age related macular degeneration, the CNV was surgically removed three days after PDT. The CNV specimens were examined by light microscopy.

Results: The patients had subfoveal classic CNV. Fluorescein angiography revealed non-perfusion of the CNV after PDT and before surgery in all eyes. The light microscopy of the CNV membranes showed swollen and damaged endothelium. Thrombus formation or vascular occlusion in the CNV vessels was not detected.

Conclusion: PDT did not cause a thrombosis of the vessels within the CNV three days after PDT. Severe endothelial damage of the CNV was observed and is likely a primary effect of PDT. Non-perfusion of the CNV at this stage is possibly secondary to occlusion at a deeper level, namely the underlying feeding choroid.

Keywords: choroidal neovascularisation; age related macular degeneration; photodynamic therapy; histopathology

Abbreviations: AMD, age related macular degeneration; CNV, choroidal neovascularisation; PAS, periodic acid Schiff; PDT, photodynamic therapy; PTAH, phosphotungstic acid haematoxylin

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