Hemorragia submacular tras terapia fotodinámica en el tratamiento de la neovascularización coroidea
- E. Díaz-de-Durana-Santa-Coloma
- M.L. Fernández-Ares
- D. Iturralde-Errea
- J.L. Salazar-Díez
- E. Vázquez-Cruchaga
- J.A. López-Garrido
ISSN: 0365-6691
Année de publication: 2006
Volumen: 81
Número: 12
Pages: 685-691
Type: Article
D'autres publications dans: Archivos de la Sociedad Española de Oftalmologia
Résumé
Purpose: 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 >- 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.
Références bibliographiques
- (1999). Treatment of age-related macular degeneration with photodynamic therapy (TAP) Study Group. Arch Ophthalmol. 117. 1329-1345
- Bresslet, NM. (2001). Photodynamic therapy of subfoveal choroidal neovascularization in age-related macular degeneration with verteporfin: two-year results of 2 randomized clinical trials-Tap report 2. Arch Ophthalmol. 119. 198-207
- (2001). Photodynamic therapy of subfoveal choroidal neovascularization in pathologic myopia with verteporfin: one-year results of a randomized clinical trial. VIP report no.1. Ophthalmology. 108. 841-852
- (2001). Verteporfin therapy of subfoveal choroidal neovascularization in age-related macular degeneration: two-year results of a randomized clinical trial including lesions with occult with no classic choroidal neovascularization--verteporfin in photodynamic therapy report 2. Am J Ophthalmol. 131. 541-560
- Arnold, JJ, Blinker, KJ, Bressler, NM, Bressler, SB, Burdan, A, Haynes, L. (2004). Acute severe visual acuity decrease after photodynamic therapy wtih verteporfin: case reports from randomized clinical trials-TAP and VIP report no. 3. Am J Ophthalmol. 137. 683-696
- Do, DV, Bressler, NM, Bressler, SB. (2004). Large submacular hemorrhages after verteporfin therapy. Am J Ophthalmol. 137. 558-560
- Theodossiadis, GP, Panaglotidis, D, Georgalas, IG, Moschos, M, Theodossiadis, PG. (2003). Retinal hemorrhage after photodynamic therapy in patients with subfoveal choroidal neovascularization caused by age-related macular degeneration. Graefes Arch Clin Exp Ophthalmol. 241. 13-18
- Gelisken, F, Inhoffen, W, Karim-Zoda, K, Grisanti, S, Partsch, M, Voelker, M. (2005). Subfoveal hemorrhage after verteporfin photodynamic therapy in treatment of choroidal neovascularization. Graefes Arch Clin Exp Ophthalmol. 243. 198-203
- Arroyo, JG, Michaud, N, Jacobiec, FA. (2003). Choroidal neovascular membranes treated with photodynamic therapy. Arch Ophthalmol. 121. 898-903