Choroidal Ischemia After Photodynamic Therapy With Verteporfin for Choroidal Neovascularization

Purpose: To report delay in choroidal perfusion suggestive of ischemia after photodynamic therapy (PDT) with verteporfin for choroidal neovascularization (CNV). Design: Observational case series. Methods: Retrospective review of all patients who developed choroidal ischemia after PDT. Results: This vascular change was found in eight (2.1%) of 373 eyes of patients treated for CNV as a result of age-related macular degeneration (AMD) and in one (0.9%) of 114 eyes treated for pathologic myopia. A decrease of 3 lines of vision was reported to occur one week after treatment in patients with AMD. At the 12-month examination, patients did not exhibit any marked changes in visual acuity. Conclusions: Choroidal ischemia was an uncommon manifestation owing to the selectivity of verteporfin therapy and the existence of abundant anastomotic vascular connections in the choroid. The low incidence of this vascular event should not preclude counseling PDT in eyes that could benefit greatly from this therapy.