[Morphological changes in exudative age-related macular degeneration after photodynamic therapy]

Exudative age-related macular degeneration was classified into two types. Type 1 had choroidal neovascularization (CNV) below the retinal pigment epithelium (RPE) and type 1+2 had CNV extended into subretinal space. The morphological changes following photodynamic therapy were investigated for the two types.

One hundred and five eyes of 104 patients(mean age; 70.2 +/- 8.5 (SD) years-old) were classified by clinical findings with stereoscopic fundus observation, fluorescein angiography, and optical coherent tomography. The eyes with no exudative changes after successful treatment were divided into two types: sub-pigment epithelial dry type and sub-sensory retinal dry type. In the former, the lesions remained below the RPE and in the latter, fibrous scars persisted in the subretinal space.

Exudation resolved in 73% of type 1 and in 67% of type 1+2 at 6 months after the initial treatment. Among eyes followed for more than one year, in 77% of type 1 and in 89% of type 1+2 the lesions became dry in a mean follow-up time of 23.9 -/+ 8.4 months with mean treatment times of 2.0 and 2.2, respectively. Type 1 improved to sub-pigment epithelial dry type, and type 1+2 to sub-sensory retinal dry type (p = 1.06 x 10(-10), chi-square test). Visual acuity of the former was better than the latter.

We considered that exudation was resolved with CNV remaining beneath the RPE in type 1, and fibrous scar tissue was favorably formed in type 1+2.