Recurrent bullous retinal detachments from photodynamic therapy for idiopathic polypoidal choroidal vasculopathy.
OBJECTIVE
To report the recurrent bullous retinal detachments as complications of photodynamic therapy (PDT) for idiopathic polypoidal choroidal vasculopathy (IPCV).


METHODS
Interventional case report.


METHODS
A pseudophakic 84-year-old-woman had IPCV and decreased vision. Angiography demonstrated macular leakage. PDT with verteporfin was applied. Two days later, visual acuity decreased from 20/50 to 20/400. Examination revealed extensive inferior subretinal fluid, which mimicked a pseudophakic rhegmatogenous retinal detachment. A scleral buckle was placed; no retinal breaks were identified.


RESULTS
Vision and fluid resolved over three weeks. Four months later, examination revealed decreased vision and persistent leakage. Two days after repeat PDT, bullous exudative macular detachment recurred. Detachment resolved over two weeks; visual acuity returned to 20/50.


CONCLUSIONS
IPCV that is treated with PDT may be complicated by iatrogenic bullous exudative retinal detachments that resemble rhegmatogenous detachments. Modified treatment parameters may reduce the risk of recurrence. The natural history likely includes spontaneous resolution and visual recovery.
Prakash
Manvi
M
The Eye Institute, Medical College of Wisconsin, Milwaukee, Wisconsin 53226-4812, USA.
Han
Dennis P
DP
D000208:Acute Disease; D000369:Aged, 80 and over; D002829:Choroid / Q000098:blood supply*; D005122:Exudates and Transudates; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D016491:Peripheral Vascular Diseases / Q000188:drug therapy*; D010778:Photochemotherapy / Q000009:adverse effects*; D019591:Pseudophakia / Q000150:complications; D012008:Recurrence; D012163:Retinal Detachment / Q000209:etiology*; D014792:Visual Acuity