Acute Severe Visual Decrease After Photodynamic Therapy with Verteporfin: Spectral-Domain OCT Features

Abstract

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.

Assessment of Differential Pharmacodynamic Effects Using Optical Coherence Tomography in Neovascular Age-Related Macular Degeneration

“…Before vascular occlusion, the release of inflammatory mediators, as well as the effects of endothelial cell injury on the already hyperpermeable CNV lesion, commonly causes acute fluid extravasation. 45,46 Transient dysfunction of the RPE, and hence the outer blood-retinal barrier, may further contribute to this temporary accumulation of fluid in the subretinal space.…”

Comparison of the optical coherence tomographic characters between acute Vogt-Koyanagi-Harada disease and acute central serous chorioretinopathy

“…Fluctuation of internal limiting membrane (ILM) was defined as at least two sets of peaks and troughs at the level of ILM (Figure 1 a). Subretinal fluid on OCT was defined as homogeneous hypo-reflective space between neurosensory retina and RPE (Figure 1 ) [ 16 ]. Pigment epithelium detachment (PED) was defined as a dome-shaped elevation of the RPE typically seen overlying a homogeneously hypo-reflective space, bound inferiorly by a visible Bruch’s membrane (Figure 1 e) [ 17 ].…”

No-Dose Photodynamic Therapy Against half-dose Photodynamic Therapy for Treatment of Central Serous Chorioretinopathy

“…3). This temporary complication has been also observed in patients treated with conventional PDT with vertepor n [29][30] To the best of our knowledge, no-dose PDT for the treatment of cCSC has not been investigated or reported previously. Other nonvisible endpoint therapies that have been used previously for cCSC include SML 7,8 and TTT [9][10][11] .…”