Changes in fundus autofluorescence in patients with choroideal neovascularization pre and post photodynamic therapy. Correlation to visual function

PURPOSE: To investigate fundus autofluorescence changes in patients with choroidal neovascularization (classic, minimally classic and occult CNV) pre and post photodynamic therapy (PDT) to correlate these changes to visual function. METHODS: Autofluorescence images were recorded in 30 consecutive eyes (30 patients) with CNV. All patients underwent a detailed ophthalmoscopic examination: best corrected visual acuity (BCVA) with Early Treatment Diabetic Retinopathy (ETDRS) charts; slit lamp examination; binocular funduscopy; OCT, AF, fluorescein and indocyanine angiography pre and post PDT (every two months from each PDT, follow-up 24 months). RESULTS: All eyes showed variations from the initial pattern. In the 43,3% of eyes we observed a marked reduction of macular AF with a minimal residual visual function and severe visual loss from the initial. In the 56,7% of eyes was evident only a minimal reduction of macular AF in correlation to a good residual visual function. CONCLUSION: Preserved AF post PDT indicates viable retinal pigment epithelium initially, which has implications for visual prognosis. Marked decrease of AF post PDT indicates loss of retinal pigment epithelium and photoreceptor with a severe visual loss. Minimal reduction of macular AF post PDT is in correlation to a good residual visual function. Autofluorescence imaging may increase our understanding of CNV in AMD after PDT. Variations in AF permit us to understand the behavior of CNV and the changes of final visual function. KEY WORDS: Choroidal neovascularization (CNV), autofluorescence (AF), retinal pigment epithelium (RPE), photodynamic therapy, visual function.