Subfoveal hemorrhage after verteporfin photodynamic therapy in treatment of choroidal neovascularization.
BACKGROUND
To identify the frequency of new subfoveal hemorrhage and its impact on visual acuity 2 weeks following verteporfin photodynamic therapy (PDT) in the treatment of predominantly classic subfoveal choroidal neovascularization (CNV) secondary to age-related macular degeneration (AMD).


METHODS
Retrospective, noncomparative, consecutive, interventional case series. At a tertiary retinal referral center, 104 eyes of 97 consecutive patients with predominantly classic subfoveal CNV were treated by PDT. Morphological outcomes include new subfoveal hemorrhage assessed on the photo review (pretreatment, 2 and 12 weeks after PDT). Visual acuity outcomes include moderate (3-5 ETDRS lines) and severe (6 and more ETDRS lines) loss of visual acuity at 2 weeks after PDT.


RESULTS
In this study, 104 eyes of 97 patients were analyzed. CNV in all eyes was secondary to AMD. New subfoveal hemorrhage was found in 22% (23/104) of the eyes 2 weeks following PDT. 17.4% (4/23) of the eyes with new subfoveal hemorrhage had moderate or severe loss of visual acuity. In such eyes the 12-week examination revealed considerable resorption of the new subfoveal hemorrhage with some improvement of visual acuity.


CONCLUSIONS
In 3.8% of the eyes that underwent PDT for predominantly classic subfoveal CNV secondary to AMD, new subfoveal hemorrhage may result in moderate or severe loss of visual acuity within 2 weeks. In all eyes with new subfoveal hemorrhage, considerable resorption of the hemorrhage and some improvement of the visual acuity were seen at 12 weeks. Candidates for PDT should be informed about the low risk of this complication.
Gelisken
Faik
F
Department of Ophthalmology I, University of Tuebingen, Germany. faik.gelisken@med.uni-tuebingen.de
Inhoffen
Werner
W
Karim-Zoda
Khakima
K
Grisanti
Salvatore
S
Partsch
Michael
M
Voelker
Michael
M
Bartz-Schmidt
Karl Ulrich
KU
D000368:Aged; D000369:Aged, 80 and over; D020256:Choroidal Neovascularization / Q000188:drug therapy* / Q000209:etiology / Q000473:pathology; D005260:Female; D005451:Fluorescein Angiography; D005584:Fovea Centralis; D006801:Humans; D008268:Macular Degeneration / Q000150:complications; D008297:Male; D008875:Middle Aged; D017319:Photosensitizing Agents / Q000009:adverse effects*; D011166:Porphyrins / Q000009:adverse effects*; D012166:Retinal Hemorrhage / Q000139:chemically induced* / Q000473:pathology / Q000503:physiopathology; D012189:Retrospective Studies; D013997:Time Factors; D000077362:Verteporfin; D014792:Visual Acuity
D017319:Photosensitizing Agents; D011166:Porphyrins; D000077362:Verteporfin