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

Photodynamic therapy-induced acute exudative maculopathy (PAEM) was frequent in circumscribed choroidal hemangioma. The intraretinal fluid increase at 3 days was the main finding. However, a self-resolving evolution and favorable prognosis were observed in most cases. 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 mu m 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 mu m (262-1,265 mu m) to 664.5 mu m after 3 days and diminished to 245 mu m 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.