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Early anatomical changes and association with photodynamic therapy induced acute exudative maculopathy in patients
Satoshi Honda1, Takeya Kohno1, Manabu Yamamoto2
1Department of Ophthalmology and Visual Science, Osaka City University Graduate School of Medicine, Osaka, 545-8585, Japan.
Abstract:
The purpose of this study was to investigate the occurrence rate and predictors of photodynamic therapy (PDT) induced acute exudative maculopathy (PAEM). This retrospective study included 39 eyes of 39 patients (32 males and 7 females), who were treated with initial PDT. PAEM was defined as an increase in central retinal thickness (CRT) of 15% or more measured by OCT on day 3 after PDT compared with baseline. Sixteen of 39 eyes (41%) were classified in the PAEM+ group. CRT and central choroidal thickness (CCT) were significantly increased at 3 days in the PAEM+ group and significantly decreased at 1 month after PDT in the PAEM- group. In a multiple comparison, neovascular age-related macular degeneration (nAMD) had a significantly higher incidence of PAEM compared to polypoidal choroidal vasculopathy (PCV) and central serous chorioretinopathy (CSC). The incidence of PAEM was lower in PCV and CSC, and higher in nAMD. BCVA at 1 month was significantly worse in the PAEM group, which may be related to visual prognosis after PDT. Since both CRT and CCT decrease at 1 month, the detection of PAEM needs to be assessed a few days after PDT.
Insights
Photodynamic therapy (PDT) can cause acute exudative maculopathy (PAEM) in 41% of patients. Neovascular age-related macular degeneration (nAMD) shows a higher PAEM incidence, impacting visual prognosis.
Area of Science:
- Ophthalmology
- Retinal Diseases
- Medical Imaging
Background:
- Photodynamic therapy (PDT) is a treatment for various eye conditions.
- Acute exudative maculopathy (PAEM) is a potential complication following PDT.
- Understanding PAEM incidence and predictors is crucial for patient management.
Purpose of the Study:
- To investigate the occurrence rate of photodynamic therapy-induced acute exudative maculopathy (PAEM).
- To identify predictors of PAEM following PDT.
- To analyze the impact of PAEM on visual prognosis.
Main Methods:
- Retrospective study of 39 eyes from 39 patients undergoing initial PDT.
- PAEM defined as ≥15% increase in central retinal thickness (CRT) on OCT 3 days post-PDT.
- Comparison of PAEM incidence across different macular diseases: neovascular age-related macular degeneration (nAMD), polypoidal choroidal vasculopathy (PCV), and central serous chorioretinopathy (CSC).
Main Results:
- PAEM occurred in 16 of 39 eyes (41%).
- CRT and central choroidal thickness (CCT) increased at 3 days in the PAEM+ group.
- nAMD showed a significantly higher PAEM incidence compared to PCV and CSC.
- Worse best-corrected visual acuity (BCVA) at 1 month was observed in the PAEM group.
Conclusions:
- PAEM is a common complication of PDT, occurring in 41% of cases.
- nAMD is associated with a higher risk of PAEM compared to PCV and CSC.
- Early detection of PAEM within days of PDT is important due to its impact on visual prognosis.
