The photodynamic occlusion of choroidal vessels using benzoporphyrin derivative

We used benzoporphyrin derivative-monoacid (BPD-MA), a new photosensitizing agent, in photodynamic therapy (PDT) to occlude choroidal vessels in the rabbit. Using BPD-MA, seven dutch-belted rabbit eyes were photodynamically treated to achieve acute choroidal vessel closure. Fundoscopy, fluorescein angiography (FA), and histology were performed 1 hour, 1 day, 3 days, 7 days, 14 days, 21 days, and 28 days after PDT. On FA, PDT-treated spots remained nonperfused until day 3 when gradual reperfusion from the periphery began to appear. By day 28 the area of PDT appeared completely reperfused. Histology of lesions showed acute damage to choroidal vascular endothelial cells and retinal pigment epithelial (RPE) cells. Over subsequent days, recovery of RPE cells and regeneration of large choroidal vascular endothelial cells occurred. In addition, retinal degeneration occurred gradually over the 28 days of follow-up. Since current argon laser therapy of retinal neovascularization causes immediate retinal damage, the ability to occlude choroidal vessels without inducing acute thermal damage holds promise for treating clinical pathologic conditions that feature abnormal neovascularization, such as age-related macular degeneration and diabetic retinopathy.