Clinicopathologic studies of age-related macular degeneration with classic subfoveal choroidal neovascularization treated with photodynamic therapy

Retina. 2001;21(5):478-86. doi: 10.1097/00006982-200110000-00010.


Background: Photodynamic therapy (PDT) is a relatively new modality that is currently under clinical and experimental evaluation for treatment of subfoveal choroidal neovascularization (CNV). The authors report the case of an 82-year-old woman who underwent verteporfin-mediated PDT for classic subfoveal CNV. Fluorescein angiography performed 2 weeks after treatment disclosed reduction of the initial area of neovascularization and leakage by approximately 60%. Three weeks after PDT, however, the area of leakage was almost the same size as that before treatment. The patient underwent submacular membranectomy almost 4 weeks after treatment. The authors describe the ultrastructural vascular changes after PDT and a clinicopathologic study of classic CNV.

Methods: The submacular membrane was studied by light and electron microscopy and immunohistochemical techniques.

Results: Ultrastructural examination of the peripheral vessels showed evidence of endothelial cell degeneration with platelet aggregation and thrombus formation. Occasional occluded vessels were surrounded by macrophages, a phenomenon previously reported to describe the process of resorption of such blood vessels. The vessels in the center of the membrane were unremarkable.

Conclusion: Photodynamic therapy causes endothelial cell damage, thrombus formation, and vascular occlusion of classic CNV in age-related macular degeneration.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Choroid / blood supply
  • Choroidal Neovascularization / drug therapy*
  • Choroidal Neovascularization / pathology
  • Endothelium, Vascular / ultrastructure
  • Female
  • Fluorescein Angiography
  • Fovea Centralis / ultrastructure*
  • Humans
  • Macular Degeneration / drug therapy*
  • Macular Degeneration / pathology
  • Photochemotherapy*
  • Photosensitizing Agents / therapeutic use*
  • Porphyrins / therapeutic use*
  • Retinal Vessels / ultrastructure
  • Verteporfin


  • Photosensitizing Agents
  • Porphyrins
  • Verteporfin