Choroidal Infarction Following Photodynamic Therapy With Verteporfin

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Choroidal circulatory disturbances associated with retinal angiomatous proliferation on indocyanine green angiography

Koizumi

Iida

Saito

et al. 2007

“…Furthermore, the collateral hypofluorescence that occurs after PDT reaches its maximum 1 week after the treatment, and is then reduced in size and intensity over time [3]. Rare complications of PDT for CNV include occlusions of deep choroidal vessels, ischemia and choroidal infarction [4].…”

Section: Discussionmentioning

confidence: 99%

Enlargement of the hypofluorescent post photodynamic therapy treatment spot after a combination of photodynamic therapy with an intravitreal injection of bevacizumab for retinal angiomatous proliferation

Rouvas¹,

Papakostas

Ladas³

et al. 2007

“…A few studies have reported that hypofluroscence after PDT is associated with the occlusion of the choriocapillaris and swelling in the adjacent retinal pigment epithelium [2]. Recently, half-dose PDT has been proposed as an effective therapeutic option for chronic CSCR to prevent retinal pigment epithelium or choriocapillaris damage [3].…”

Section: Dear Editormentioning

confidence: 99%

Capillary dropout after photodynamic therapy in a patient with Bechet’s disease

Chien

Chang

Chen

et al. 2009

Dear Editor:A 43-year-old healthy male was referred to our hospital for a 1-year history of metamorphopsia in his left eye. At presentation, the best-corrected visual acuity (BCVA) was 20/30 in the left eye, with a circumscribed serous retinal detachment over the macula of the left eye (Fig. 1a). The BCVA in the fellow eye was 20/20. The patient had no history of ocular trauma or intraocular surgery. In both the eyes, the intraocular pressure was normal, pupil reflex was brisk, and the aqueous and vitreous humour were clear. He was diagnosed with chronic central serous chorioretinopathy (CSCR) because optical coherence topography (OCT) showed localized subretinal fluid accumulation (Fig. 1b), and fluorescence angiography (FAG) revealed a smoke-stack appearance of dye leakage at the late stage (Fig. 1d). Since CSCR persisted after observation for 3 months, photodynamic therapy (PDT) with half-dose (3 mg/m 2 ) Verteporfin (Visudyne; Novartis AG, Bulach, Switzerland) was performed uneventfully in the left eye.One month after PDT, he revisited our hospital with deteriorated vision of 20/60 in the left eye and recently recurrent painful oral ulcers. Ocular examinations were inconclusive, but FAG revealed resolved CSCR and focal capillary dropout in the fovea (Fig. 2c,d). Systemic inflammatory disease was suspected, and hence systemic survey was performed. The patient was diagnosed as having incomplete Bechet's disease (BD) on the basis of the presence of aphthous ulcers, acneiform papules over lower limbs and previous healed genital ulcers in the month after PDT. Then he started to receive immunosuppressant therapy, which was prescribed by a rheumatologist. After 3 months, his BCVA recovered to 20/25 with resolved metamorphopsia, and FAG showed persistent staining in the late phase over the previous capillary dropout area.Verteporfin PDT is effective by causing early occlusion of both choroidal neovasculature and normal choroidal vessels on the first day and progressive occlusion only of the neovasculature within a week [1]. A few studies have reported that hypofluroscence after PDT is associated with the occlusion of the choriocapillaris and swelling in the adjacent retinal pigment epithelium [2]. Recently, half-dose PDT has been proposed as an effective therapeutic option for chronic CSCR to prevent retinal pigment epithelium or choriocapillaris damage [3]. However, there have been no reports regarding vessel occlusion or nonperfusion at the level of the inner retina.BD is characterized by relapsing vasculitis [4], and retinal vasculitis with vessel occlusion is occasionally reported as its ocular complication. Ocular involvement in cases with BD is often observed at late stages, and its manifestations include uveitis, hypopyon, vitritis, vasculitis, exudate accumulation, optic hyperemia or atrophy, and cystoid macular edema [4]. Prothrombotic hemostatic abnormalities, endothelial cell dysfunction, and enhanced adhesion of neutrophils have been proposed as the factors responsible for BD-related vessel occlusion. How...