Clinicopathologic tudy after ubmacular removal of choroidal neovacular membrane treated with verteporfin ocular photodynamic therapy

Purpoe To report the clinicopathologic finding after ubmacular removal of choroidal neovacular membrane (CNV) treated with verteporfin ocular photodynamic therapy. Deign Interventional cae erie. Method Retropective review of eight eye of eight patient who underwent ubmacular urgery for CNV after having previouly received verteporfin ocular photodynamic therapy for preumed ocular hitoplamoi (one patient), age-related macular degeneration ([AMD] three patient) pathologic myopia (two patient), punctate inner choroiditi (one patient), and idiopathic CNV (one patient). All cae had undergone ocular photodynamic therapy with verteporfin uing tandard protocol. ix of eight patient uffered a ubmacular hemorrhage after ocular photodynamic therapy, and two of eight patient refued further ocular photodynamic therapy. All patient ubequently had ubmacular urgery with removal of the CNV. One membrane wa routinely proceed, ectioned, and tained with hematoxylin and eoin. Five membrane were tained with toluidine blue for light microcopic examination. emithin (1.0 μm) ection were cut and tained with uranyl acetate-lead citrate for tranmiion electron microcopy. Reult Choroidal neovacular membrane were removed at 3 day (preumed ocular hitoplamoi), 29 day (punctate inner choroiditi), 63 day (AMD, pathologic myopia), 66 day (AMD), 107 day (pathologic myopia), 116 day (AMD), and 152 day (idiopathic) after verteporfin ocular photodynamic therapy. Hitopathologic and ultratructural examination howed area of vacular occluion at 3 day that were not een at later time point. All pecimen had patent CNV. There were ign of vacular damage with extravaated erythrocyte and fibrin, pigment clumping in cell, and inflammatory cell in all but the 3-day pecimen. Concluion Thi cae erie preent data only from patient who refued repeat treatment with ocular photodynamic therapy or who developed ubmacular hemorrhage after initial photodynamic therapy. Hitopathologic evaluation of CNV 3 day after verteporfin ocular photodynamic therapy howed partial vacular occluion that wa not preent in later pecimen. Thee later pecimen demontrated evidence of vacular damage. Verteporfin ocular photodynamic therapy doe not appear to lead to permanent and complete occluion of the CNV. Thu, treatment that lead to permanent cloure of CNV without damage to the retinal pigment epithelium and enory retina are till needed.