PHOTODYNAMIC THERAPY-INDUCED ACUTE EXUDATIVE MACULOPATHY IN A CASE SERIES OF CIRCUMSCRIBED CHOROIDAL HEMANGIOMA

Abstract

Purpose: To describe the incidence, features, and clinical outcomes of photodynamic therapy–induced acute exudative maculopathy (PAEM) in circumscribed choroidal hemangioma. Methods: Prospective series of 10 patients who underwent standard-fluence photodynamic therapy for circumscribed choroidal hemangioma. Best-corrected visual acuity in the Early Treatment Diabetic Retinopathy Score and swept-source optical coherence tomography were performed before PDT and 3 days and 1 month after PDT. Central retinal thickness, circumscribed choroidal hemangioma retinal thickness, and subretinal fluid were measured. Photodynamic therapy–induced acute exudative maculopathy was considered as an increase ≥50 µm in subretinal fluid or intraretinal fluid or the appearance of fibrin 3 days after photodynamic therapy. Results: Six men and four women were included; median age was 55 years (19–69 years). The incidence rate of PAEM was 7 of 10. Five PAEM patients showed an increase in intraretinal fluid, two in subretinal fluid, and one developed abundant fibrin. Median best-corrected visual acuity at baseline was 57.5 letters (5–76 letters) being stable at 1 month (64 letters; 5–80) (P = 0.03). Median central retinal thickness increased from 516 µm (262–1,265 µm) to 664.5 µm after 3 days and diminished to 245 µm after 1 month (156–1,363) (P ≤ 0.022). In 6 of 7 of PAEM, a complete resolution of the fluid was obtained. Conclusion: Photodynamic therapy–induced acute exudative maculopathy was frequent in circumscribed choroidal hemangioma, although a favorable prognosis was observed in most cases.