Complications after photodynamic therapy.
OBJECTIVE
To evaluate the incidence of complications of photodynamic therapy (PDT) with verteporfin in subfoveal choroidal neovascularizations secondary to age-related macular degeneration and pathologic myopia.


METHODS
In this retrospective interventional case series, the occurrence of complications after PDT in a clinical setting was analyzed. Consecutive medical records of patients with age-related macular degeneration and pathologic myopia treated with PDT were reviewed for complications. Complications included treatment-related systemic adverse events, injection site effects, and ocular adverse events.


RESULTS
We included 273 patients (198 with age-related macular degeneration and 75 with pathologic myopia) in the study. A total of 485 photodynamic treatment sessions were performed. Infusion-related back or chest pain was reported by 6 patients (2.2%; 95% confidence interval [CI], 0.8%-4.7%). Injection site effects, extravasation, and photosensitivity reactions were not observed. Dyspnea and flushing during infusion were observed in 2 patients (0.7%; 95% CI, 0.09%-2.6%). Body pain, shortness of breath, and elevated blood pressure were noted in 13 patients (4.8%; 95% CI, 2.6%-8.0%). General pruritus was described by 6 patients (2.2%; 95% CI, 0.8%-4.7%), starting 4 hours after the infusion of verteporfin, and resolved within 72 hours after PDT. A total of 8 patients (2.9%; 95% CI, 1.3%-5.7%) reported an acute severe visual acuity decrease of at least 4 Early Treatment Diabetic Retinopathy Study lines occurring within 7 days of treatment.


CONCLUSIONS
Complications associated with PDT are uncommon, but there were limitations of retrospective studies for identifying safety problems. Complications like acute severe visual events may occur in about 3% of patients. We believe that this risk is outweighed by the benefits of PDT on visual function in most patients.
Schnurrbusch
Ute E K
UE
Department of Ophthalmology, University Eye Hospital, Bern, Switzerland.
Jochmann
Claudia
C
Einbock
Wilma
W
Wolf
Sebastian
S
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D020256:Choroidal Neovascularization / Q000188:drug therapy* / Q000209:etiology; D005128:Eye Diseases / Q000139:chemically induced*; D005260:Female; D006801:Humans; D007267:Injections; D008268:Macular Degeneration / Q000150:complications; D008297:Male; D008875:Middle Aged; D047728:Myopia, Degenerative / Q000150:complications; D010778:Photochemotherapy / Q000009:adverse effects*; D017319:Photosensitizing Agents / Q000009:adverse effects*; D011166:Porphyrins / Q000009:adverse effects*; D012189:Retrospective Studies; D012307:Risk Factors; D000077362:Verteporfin; D014822:Vitreous Body
D017319:Photosensitizing Agents; D011166:Porphyrins; D000077362:Verteporfin