Risk factors for retinal hemorrhage after photodynamic therapy in age-related macular degeneration.
BACKGROUND
Subretinal or intraretinal hemorrhage may occur after photodynamic therapy (PDT). However, risk factors for post-PDT hemorrhage have not yet been investigated.


METHODS
We reviewed the medical records of patients who had undergone PDT for subfoveal choroidal neovascularization secondary to age-related macular degeneration. Primary outcomes were the occurrences of hemorrhages at 2 and 12 weeks after PDT. To identify the risk factors of hemorrhages after treatment, ocular and systemic factors were investigated. The secondary outcome was visual acuity.


RESULTS
Ninety-two eyes from 92 patients were analyzed. New hemorrhages developed in 9 (9.8%) within 2 weeks and in 8 (8.3%) between 2 and 12 weeks after PDT. Hypertension [odds ratio (OR) 356.9, 95% confidence interval (CI) 3.7-34,487.1], minimally classic lesion (OR 53.4, 95% CI 2-1,429) and advanced age (OR 1.2, 95% CI 1-1.5) were related to hemorrhagic events within 2 weeks after PDT. A tendency toward recurrent hemorrhage was noted after repeat treatments (p < 0.05). Forty-four percent of the patients with a hemorrhagic event within 2 weeks after PDT experienced decreased vision.


CONCLUSIONS
Hypertension, minimally classic lesion, advanced age and a previous hemorrhagic event were associated with the development of hemorrhage within 2 weeks after PDT.
Oh
In Kyung
IK
Department of Ophthalmology, Korea University Medical Center, Seoul, Korea.
Huh
Kuhl
K
Oh
Jaeryung
J
D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology*; D015994:Incidence; D008268:Macular Degeneration / Q000188:drug therapy* / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D010778:Photochemotherapy / Q000706:statistics & numerical data*; D017319:Photosensitizing Agents / Q000627:therapeutic use; D011166:Porphyrins / Q000627:therapeutic use; D012008:Recurrence; D012166:Retinal Hemorrhage / Q000188:drug therapy* / Q000453:epidemiology*; D015861:Retinal Neovascularization / Q000188:drug therapy / Q000453:epidemiology; D012307:Risk Factors; D000077362:Verteporfin; D014792:Visual Acuity
D017319:Photosensitizing Agents; D011166:Porphyrins; D000077362:Verteporfin