Large submacular hemorrhages after verteporfin therapy.
OBJECTIVE
To report the occurrence of large submacular hemorrhages after photodynamic therapy with verteporfin in age-related macular degeneration patients with subfoveal choroidal neovascularization (CNV) composed of occult with no classic CNV in whom the hemorrhage precluded determining if additional therapy should be given within 3 months after initiation of treatment.


METHODS
Retrospective, noncomparative case series.


METHODS
The records of all age-related macular degeneration patients who received verteporfin therapy for subfoveal lesions composed of occult with no classic CNV between February and July 2001 at The Wilmer Eye Institute were reviewed. Subjects who reported either having undergone a procedure to remove intraocular blood before a month 3 follow-up visit, or who had submacular hemorrhage at the month 3 visit that was severe enough to preclude determining if additional verteporfin therapy should be given were identified.


RESULTS
Fifty-five eyes of 52 patients were reviewed. Five eyes (9% [95% confidence interval, 1.4%-16.6%]) developed submacular hemorrhage that precluded determining if additional verteporfin therapy should be given. Visual acuity 3 months after documentation of the hemorrhage decreased a median of 8.5 lines compared with pretreatment acuity.


CONCLUSIONS
Even in the absence of acute severe visual acuity decrease, submacular hemorrhage after verteporfin therapy can be associated with severe vision loss and preclude determining if additional therapy should be given.
Do
Diana V
DV
The Wilmer Ophthalmological Institute, The Johns Hopkins University School of Medicine, Baltimore, Maryland 21287, USA. sbressler@jhmi.edu
Bressler
Neil M
NM
Bressler
Susan B
SB
D000368:Aged; D000369:Aged, 80 and over; D020256:Choroidal Neovascularization / Q000188:drug therapy; D005260:Female; D006801:Humans; D008266:Macula Lutea; D008268:Macular Degeneration / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D010778:Photochemotherapy / Q000009:adverse effects; D017319:Photosensitizing Agents / Q000009:adverse effects* / Q000627:therapeutic use; D011166:Porphyrins / Q000009:adverse effects* / Q000627:therapeutic use; D012166:Retinal Hemorrhage / Q000139:chemically induced* / Q000175:diagnosis; D012189:Retrospective Studies; D000077362:Verteporfin; D014792:Visual Acuity
D017319:Photosensitizing Agents; D011166:Porphyrins; D000077362:Verteporfin