Photodynamic Therapy for Choroidal Neovascularization Associated With Submacular Hemorrhage in Age-Related Macular Degeneration

Abstract

To describe visual acuity results after photodynamic therapy (PDT) with verteporfin for choroidal neovascularization in age-related macular degeneration (AMD) associated with large submacular hemorrhage (SMH). Eyes that had AMD, at least 12 months' follow-up, and SMH of at least 2.5 mm2, and had received no other treatment modality in conjunction with PDT, were divided into two groups: eyes with spontaneous SMH that was treated with PDT and eyes with SMH that occurred following PDT treatment. The presence of SMH did not preclude the patients from undergoing further PDT. Mean acuity of the spontaneous SMH group was 20/294 initially and 20/252 after 12 months. Mean acuity of the post-PDT SMH group was 20/336 initially and 20/406 after 12 months. Initial and 12-month acuities in both groups were not statistically different. Mean size of the hemorrhage was 11.5 mm2 in the spontaneous SMH group and 17.8 mm2 in the post-PDT SMH group. Subgroup analysis showed no statistically significant difference between initial and final visual acuities, regardless of the presence of blood under the fovea. Analysis by size of the SMH showed only the spontaneous SMH group with hemorrhages over 10 mm2 to have a statistically significant difference in visual acuity at 12 months (P= .0001; initial acuity, 20/230; 12-month acuity, 20/456). Eyes treated with PDT for choroidal neovascularization associated with submacular hemorrhage and AMD maintained stable vision over 12 months.