[Submacular hemorrhage following photodynamic therapy in the treatment of choroidal neovascularization].
OBJECTIVE
To describe the incidence, clinical features and evolution of submacular hemorrhage (SMH) occurring after photodynamic therapy (PDT) with verteporfin in the treatment of choroidal neovascularization (CNV).


METHODS
A retrospective analysis of the patients treated with PDT in our hospital between July 2002 and May 2005 was undertaken.


RESULTS
8 out of 504 eyes treated with PDT (1.58%) developed SMH; 4 of them (0.79%) required surgical attack. The incidence of SMH for every application of PDT was 0.65% (8/1221). The underlying disorder defined was age-related macular degeneration (AMD) in 7 cases (87.5%), and high myopia in one case (12.5%). Regarding the type of lesion, 5 were occult (62.5%; p=0.01), 1 predominantly classic, 1 minimally classic, and the last one was not classified. The average final visual acuity (VA) was 0.057, with 25% of patients having a VA >or= 0.1. Patients lost 4 Snellen lines on average.


CONCLUSIONS
SMH after PDT was an event of unknown etiology and low frequency. The incidence in our series (1.58%) was comparable with that described in the world literature (0.24-9.0%). The greatest incidence of AMD was in the occult group with no classic type of CNV, suggesting a possible higher risk for SMH in this type of lesion. It is mandatory to inform patients of the possibility of this complication, which can compromise the visual result of the PDT, and sometimes require surgery. The low risk of SMH related to the PDT justifies its application when it is indicated.
Díaz-de-Durana-Santa-Coloma
E
E
Servicio de Oftalmología, Hospital de Galdakao, Vizcaya, España. lezeaga@vodafone.es
Fernández-Ares
M L
ML
Iturralde-Errea
D
D
Salazar-Díez
J L
JL
Vázquez-Cruchaga
E
E
López-Garrido
J A
JA
D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000009:adverse effects; D020256:Choroidal Neovascularization / Q000188:drug therapy*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D010778:Photochemotherapy / Q000009:adverse effects*; D017319:Photosensitizing Agents / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D011166:Porphyrins / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D012166:Retinal Hemorrhage / Q000139:chemically induced* / Q000453:epidemiology / Q000601:surgery; D012189:Retrospective Studies; D000077362:Verteporfin; D014792:Visual Acuity; D014821:Vitrectomy
D000925:Anticoagulants; D017319:Photosensitizing Agents; D011166:Porphyrins; D000077362:Verteporfin