Back pain after photodynamic therapy with verteporfin.
OBJECTIVE
To report the incidence of back pain after photodynamic therapy, which suggests methods for prevention that are related to its pathogenesis.


METHODS
Retrospective case series.


METHODS
We retrospectively observed 548 patients who had undergone photodynamic therapy with verteporfin.


RESULTS
Of 548 patients at the first treatment, 14 patients (2.6%) experienced pain during the infusion. Eleven patients were being treated for age-related macular degeneration; their mean age was 81 years, which significantly differed from the mean age of the overall age-related macular degeneration group (P = .003). The pain was mild in eight patients, moderate in four patients, and severe in two patients, with dyspnea and precordial pain. Five of the 14 patients had further courses of photodynamic therapy. After being treated prophylactically 60 minutes before photodynamic therapy, only one patient reported further mild pain.


CONCLUSIONS
The biologic mechanisms of back pain may involve a high level of circulating thromboxanes that are induced by the liposomal composition of verteporfin. Prevention may include hydration, nonsteroidal anti-inflammatory drugs, and halving the infusion rate.
Department of Ophthalmology, Melegnano Hospital, Via Pandina 1, Vizzolo Predabissi, Melegnano, 20077 Milan, Italy. pece.retina@mclink.it
Alfredo
A
Pece
Maria
M
Vadalà
Renato
R
Manzi
Giliola
G
Calori
D000368:Aged; D000369:Aged, 80 and over; D001416:Back Pain / Q000139:chemically induced*; D020256:Choroidal Neovascularization / Q000188:drug therapy / Q000209:etiology; D005260:Female; D006801:Humans; D015994:Incidence; D007262:Infusions, Intravenous; D008268:Macular Degeneration / Q000150:complications / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D047728:Myopia, Degenerative / Q000150:complications; D010778:Photochemotherapy / Q000009:adverse effects*; D017319:Photosensitizing Agents / Q000008:administration & dosage / Q000009:adverse effects*; D011166:Porphyrins / Q000008:administration & dosage / Q000009:adverse effects*; D012189:Retrospective Studies; D000077362:Verteporfin
D017319:Photosensitizing Agents; D011166:Porphyrins; D000077362:Verteporfin