Choroidal infarction after photodynamic therapy combined with bevacizumab and triamcinolone reversed by tissue plasminogen activator: case report.
OBJECTIVE
To present a case of choroidal infarction after combined therapy of photodynamic therapy, intravitreal bevacizumab, and sub-Tenon triamcinolone injection salvaged by tissue plasminogen activator administration.


METHODS
Interventional case report.


RESULTS
Combined therapy of full-fluence photodynamic therapy, intravitreal bevacizumab, and sub-Tenon triamcinolone injection was given on the same day to treat neovascular age-related macular degeneration in an 82-year-old patient. Subsequent acute visual loss and marked macular edema as a result of choroidal infarction were noted. Intravitreal and sub-Tenon administration of tissue plasminogen activator were performed 9 days later to salvage the choroidal infarction, and visual improvement was noted. Fundoscopy and optical coherent tomography showed almost complete resolution of macular edema. Indocyanine green angiography revealed reperfusion of the choroidal vessels.


CONCLUSIONS
Choroidal infarction may happen after combined therapy. Tissue plasminogen activator administration may reverse the infarction and help visual recovery.
*Department of Ophthalmology, Changhua Christian Hospital, Changhua, Taiwan †School of Medicine, Chung Shan Medical University, Taichung, Taiwan ‡Department of Optometry, Chung Hwa University of Medical Technology, Tainan, Taiwan.
San-Ni
SN
Chen
Chun-Ju
CJ
Lin
Kun-Hsien
KH
Li
Jiunn-Feng
JF
Hwang