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Feeder Vessel Therapy.Visudyne photodynamic therapy (PDT) has provided considerable improvement in patient care of subfoveal choroidal neovascularization (CNV). Patients tend to loose vision for a few months after the initial treatment, but the 4-year proven stability in vision most often provides an acceptable quality of life, sometimes with additional low vision rehabilitation. The initial visual acuity loss, borderline cost-effectiveness, and subgroups of patients not responding to PDT warrant improving the symptomatic treatment of subfoveal CNV. Today, the most tempting solution would be to combine PDT with an occlusion of the feeder vessel (FV). METHODS: Two patients are described in whom the feeder vessel was occluded using modifications of the classic PDT treatment method. The FV was identified in both patients using fluorescein and indocyanine green angiographies at a recorded video rate using a modified scanning laser ophthalmoscope (Rodenstock SLO). The feeder vessel of the first patient was occluded by minimal photocoagulation immediately after a Visudyne PDT treatment in order to take advantage of the reduced blood flow within the feeder vessel.
Feeder vessel treatment for wet age-related macular degeneration (AMD) was the subject of a seminar/workshop held in Chicago in June 2001. The program aimed to introduce the techniques of high-speed indocyanine green angiography (ICG) for feeder vessel identification and feeder vessel laser treatment. This modality has the ability to improve vision in many patients with subfoveal choroidal neovascularization (CNV).Patients receiving photodynamic therapy (PDT) with verteporfin (Visudyne, Novartis AG), a new treatment for subfoveal choroidal neovascularization (CNV) secondary to age-related macular degeneration (AMD) and pathologic myopia, should be scheduled for follow-up every 12 weeks (+/-2 weeks) after the initial treatment. However, important data from clinical practice and from small series studies suggest that this period between treatment may be too long for some patients.