Resumo

DIAZ-DE-DURANA-SANTA-COLOMA, E. et al. Submacular hemorrhage following photodynamic therapy in the treatment of choroidal neovascularization. Arch Soc Esp Oftalmol [online]. 2006, vol.81, n.12, pp.685-691. ISSN 0365-6691.

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.

Palavras-chave : Submacular hemorrhage; age-related macular degeneration; photodynamic therapy; verteporfin; choroidal neovascularization.

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