Acute severe visual decrease after photodynamic therapy with verteporfin: spectral-domain OCT features.
In this report, spectral-domain optical coherence tomography (OCT) was used to characterize the acute morphologic alterations that occur when photodynamic therapy with verteporfin results in an acute severe visual decrease. The clinical and imaging records of a patient with neovascular age-related macular degeneration who suffered this complication were reviewed. Using spectral-domain OCT, two relatively distinct subretinal fluid compartments were visualized: a sparsely hyperreflective pocket of subretinal fluid overlying the fibrovascular pigment epithelial detachment, consistent with fibrinous exudation, and a more homogeneously hyporeflective compartment at the periphery of the choroidal neovascular lesion, consistent with serous exudation. The higher axial resolution, and greater sensitivity, of spectral-domain OCT allows improved visualization of the subretinal space. As experience with spectral-domain OCT grows, new parameters will emerge-such as those related to subretinal fluid-that will facilitate improvements in both the qualitative and quantitative evaluation of macular disease.
Doheny Retina Institute, Doheny Eye Institute, Department of Ophthalmology, Keck School of Medicine, University of Southern California, 1450 San Pablo Street, Los Angeles, CA 90033, USA.
Pearse A
PA
Keane
Elda
E
Aghaian
Yanling
Y
Ouyang
Lawrence P
LP
Chong
Srinivas R
SR
Sadda
D000208:Acute Disease; D000369:Aged, 80 and over; D020256:Choroidal Neovascularization / Q000175:diagnosis / Q000188:drug therapy; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D008268:Macular Degeneration / Q000175:diagnosis / Q000188:drug therapy; D010778:Photochemotherapy / Q000009:adverse effects*; D017319:Photosensitizing Agents / Q000009:adverse effects; D011166:Porphyrins / Q000009:adverse effects; D012163:Retinal Detachment / Q000175:diagnosis* / Q000209:etiology / Q000378:metabolism / Q000503:physiopathology; D058471:Subretinal Fluid / Q000378:metabolism; D041623:Tomography, Optical Coherence; D000077362:Verteporfin; D014786:Vision Disorders / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D014792:Visual Acuity / Q000502:physiology
D017319:Photosensitizing Agents; D011166:Porphyrins; D000077362:Verteporfin