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Subfoveal hemorrhage after verteporfin photodynamic therapy in treatment of choroidal neovascularization

  • Clinical Investigation
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Abstract

Background

To identify the frequency of new subfoveal hemorrhage and its impact on visual acuity 2 weeks following verteporfin photodynamic therapy (PDT) in the treatment of predominantly classic subfoveal choroidal neovascularization (CNV) secondary to age-related macular degeneration (AMD).

Methods

Retrospective, noncomparative, consecutive, interventional case series. At a tertiary retinal referral center, 104 eyes of 97 consecutive patients with predominantly classic subfoveal CNV were treated by PDT. Morphological outcomes include new subfoveal hemorrhage assessed on the photo review (pretreatment, 2 and 12 weeks after PDT). Visual acuity outcomes include moderate (3–5 ETDRS lines) and severe (6 and more ETDRS lines) loss of visual acuity at 2 weeks after PDT.

Results

In this study, 104 eyes of 97 patients were analyzed. CNV in all eyes was secondary to AMD. New subfoveal hemorrhage was found in 22% (23/104) of the eyes 2 weeks following PDT. 17.4% (4/23) of the eyes with new subfoveal hemorrhage had moderate or severe loss of visual acuity. In such eyes the 12-week examination revealed considerable resorption of the new subfoveal hemorrhage with some improvement of visual acuity.

Conclusions

In 3.8% of the eyes that underwent PDT for predominantly classic subfoveal CNV secondary to AMD, new subfoveal hemorrhage may result in moderate or severe loss of visual acuity within 2 weeks. In all eyes with new subfoveal hemorrhage, considerable resorption of the hemorrhage and some improvement of the visual acuity were seen at 12 weeks. Candidates for PDT should be informed about the low risk of this complication.

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References

  1. Aisenbrey S, Lafout BA, Szurmann P, Grisanti S, Luke C, Krott R, Thumann G, Fricke J, Neugebauer A, Hilgers RD, Esser P, Walter P, Bartz-Schmidt KU (2002) Macular translocation with 360° retinotomy for exudative age-related macular degeneration. Arch Ophthalmol 120:431–439

    PubMed  Google Scholar 

  2. Bird AC, Bressler NM, Bressler SB, Chisholm IH, Coscas G, Davis MD, de Jong PT, Klaver CC, Klein BE, Klein R et al (1995) An international classification and grading system for age-related maculopathy and age-related macular degeneration. Surv Ophthalmol 39:367–374

    CAS  PubMed  Google Scholar 

  3. Eyetech Study Group (2002) Preclinical and phase 1A clinical evaluation of an anti-VEGF Pegylated Aptamer (EYE001) for the treatment of exudative age-related macular degeneration. Retina 22:143–152

    PubMed  Google Scholar 

  4. Gelisken F, Inhoffen W, Partsch M, Schneider U, Kreissig I (2001) Retinal pigment epithelial tear after photodynamic therapy for choroidal neovascularization. Am J Ophthalmol 131(4):518–520

    Article  CAS  PubMed  Google Scholar 

  5. Holz FG, Engenhart-Cabillic R, Unnebrink K, Bellmann C, Pritsch M, Voelcker HE for the RAD-Study Group (1999) A prospective, randomized, double-blind trial on radiation therapy for neovascular age-related macular degeneration (RAD Study). Ophthalmology 106:2239–2247

    Article  PubMed  Google Scholar 

  6. de Juan E Jr, Loewenstein A, Bressler NM, Alexander J (1998) Translocation of the retina for management of subfoveal choroidal neovascularization. II. A preliminary report in humans. Am J Ophthalmol 125:635–646

    Article  PubMed  Google Scholar 

  7. Macular Photocoagulation Study Group (1991) Argon laser photocoagulation for neovascular maculopathy: five-year results from randomized clinical trials. Arch Ophthalmol 109:1109–1114

    PubMed  Google Scholar 

  8. Macular Photocoagulation Study Group (1991) Subfoveal neovascular lesions in age-related macular degeneration: guidelines for evaluation and treatment in Macular Photocoagulation Study Group. Arch Ophthalmol 109:1242–1257

    PubMed  Google Scholar 

  9. Macular Photocoagulation Study Group (1993) Laser photocoagulation of subfoveal neovascular lesions of age-related macular degeneration: updated findings from two clinical trials. Arch Ophthalmol 111:1200–1209

    PubMed  Google Scholar 

  10. Macular Photocoagulation Study Group (1994) Visual outcome after laser photocoagulation for subfoveal choroidal neovascularization secondary to age-related macular degeneration: the influence of initial lesion size and initial visual acuity. Arch Ophthalmol 112:480–488

    PubMed  Google Scholar 

  11. Michels S, Schmidt-Erfurth U (2003) Sequence of early vascular events after photodynamic therapy. Invest Ophthalmol Vis Sci 5:2147–2154

    Article  Google Scholar 

  12. Pece A, Introini U, Bottoni F, Brancato R (2001) Acute retinal pigment epithelial tear after photodynamic therapy. Retina 21:661–665

    Article  CAS  PubMed  Google Scholar 

  13. Reichel E, Berrocal AM, Ip M, Kroll AJ, Desai V, Duker JS, Puliafito CA (1999) Transpupillary thermotherapy of occult subfoveal choroidal neovascularization in patients with age-related macular degeneration. Ophthalmology 106:1908–1914

    Article  CAS  PubMed  Google Scholar 

  14. Ryan SJ, Stout JT, Dugel PU (1994) Subretinal neovascularization. In: Ryan SJ (ed) Retina, vol 2. Mosby, St Louis, pp 1027–1047

  15. Schmidt-Erfurth U, Miller JW, Sickenberg M, Laqua H, Barbazetto I, Gragoudas ES, Zografos L, Piguet B, Pournaras CJ, Donati G, Lane AM, Birngruber R, van den Berg H, Strong HA, Manjuris U, Gray T, Fsadni M, Bressler NM (1999) Photodynamic therapy with verteporfin for choroidal neovascularization caused by age-related macular degeneration. Results of retreatments in a phase 1 and 2 study. Arch Ophthalmol 117:1177–1187

    CAS  PubMed  Google Scholar 

  16. Schmidt-Erfurt U, Laqua H, Schlötzer-Schrehard U, Viestenz A, Naumann GOH (2002) Histopathologic changes following photodynamic therapy in human eyes. Arch Ophthalmol 120:835–844

    PubMed  Google Scholar 

  17. Submacular Surgery Trials Pilot Study Investigators (2000) Submacular surgery trials randomized pilot trial of laser photocoagulation versus surgery for recurrent choroidal neovascularization secondary to age-related macular degeneration. I. Ophthalmic outcomes. Report number 2. Am J Ophthalmol 130:387–407

    Article  PubMed  Google Scholar 

  18. Theodossiadis GP, Panagiotidis 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

    CAS  PubMed  Google Scholar 

  19. Thomas MA, Dickinson JD, Melberg NS, Ibanez HE, Dhaliwal RS (1994) Visual results after surgical removal of subfoveal choroidal neovascular membranes. Ophthalmology 101:1384–1396

    CAS  PubMed  Google Scholar 

  20. Treatment of Age-Related Macular Degeneration with Photodynamic Therapy (TAP) Study Group (1999) Photodynamic therapy of subfoveal choroidal neovascularization in age-related macular degeneration with verteporfin. One-year results of 2 randomized clinical trials. TAP Report 1. Arch Ophthalmol 117:1329–1345

    PubMed  Google Scholar 

  21. Treatment of Age-Related Macular Degeneration with Photodynamic Therapy (TAP) Study Group (1999) 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 117:1329–1345

    PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Ophthalmology I, University of Tuebingen, Schleichstr. 12, 72076, Tuebingen, Germany

    Faik Gelisken, Werner Inhoffen, Khakima Karim-Zoda, Salvatore Grisanti, Michael Partsch, Michael Voelker & Karl Ulrich Bartz-Schmidt

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  1. Faik Gelisken
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  2. Werner Inhoffen
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  3. Khakima Karim-Zoda
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  4. Salvatore Grisanti
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  5. Michael Partsch
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  6. Michael Voelker
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  7. Karl Ulrich Bartz-Schmidt
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Corresponding author

Correspondence to Faik Gelisken.

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The authors have no financial interest related to the manuscript.

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Gelisken, F., Inhoffen, W., Karim-Zoda, K. et al. Subfoveal hemorrhage after verteporfin photodynamic therapy in treatment of choroidal neovascularization. Graefe's Arch Clin Exp Ophthalmol 243, 198–203 (2005). https://doi.org/10.1007/s00417-004-0959-y

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  • DOI: https://doi.org/10.1007/s00417-004-0959-y

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