The prognosis of cases with massive subretinal hemorrhage after photodynamic therapy.

PURPOSE To investigate cases with massive subretinal hemorrhage after photodynamic therapy (PDT). SUBJECTS AND METHODS We studied four cases (3 men and 1 woman, mean 80.5 years old) with massive subretinal hemorrhage after PDT about type of disease, spot size, period to the onset of hemorrhage, visual acuity (VA) before and after PDT. RESULTS Four cases consisted of one with age-related macula degeneration (AMD) and 3 with polypoidal choroidal vasculopathy (PCV). The average spot size of PDT was 5525microm. Two patients underwent the second PDT about 3 months after the initial PDT. Four periods to the onset of hemorrhage were 22, 27, 137, and 208 days respectively. The latter 2 cases underwent PDT twice, and the periods were the days from the initial PDT. Two patients among four underwent vitrectomy. Average VA before PDT was 0.20, and the final one was 0.02 after PDT. CONCLUSIONS PDT has a risk to cause massive subretinal hemorrhage leading to grave visual disturbance. Especially PDT for PCV seems to have more risk. Therefore we need to inform patients about the risk before PDT, since treating patients with massive subretinal hemorrhage is very difficult.