[Cerebrovascular accident following photodynamic therapy]

Severe complications following dynamic phototherapy are very rare. We report the case of a patient who went into a vigilant coma after a second dynamic phototherapy treatment.

A 75-year-old man reported to the ophthalmology consultation for subfoveal choroidal neovascularization of the right eye. The first course of phototherapy treatment was administered that day. After 3 months, persistent progression of angiographic lesions led to the decision to perform a second course of dynamic phototherapy. Twelve hours later, finger paraesthesia occurred, followed 1 h later by the onset of vigilant coma secondary to massive right frontoparietal ischemia. The patient died following complications of the coma.

More severe complications have been described, in particular cases of syncope or chest pain with no infarction. It is thought that Verteporfin may have played a role in our patient's brain ischemia. As Verteporfin continues to be widely used, physicians must be alert to the possibility of serious adverse events associated with its use.