Spontaneous resolution of photodynamic therapy-induced acute exudative maculopathy in a patient suffering from polypoidal choroidal vasculopathy: A case report with 3-year follow-up.

Abstract

A 60-year-old woman suffering from polypoidal choroidal vasculopathy (PCV) was treated with photodynamic therapy (PDT). The treatment spot was small (850 µm) and was targeted only against the lesion and not the surrounding vascular network. Three days later, she complained of severe visual impairment and the clinical examination set the diagnosis of PDT-induced acute exudative maculopathy (PAEM). Further examinations 3 days later demonstrated on the one hand that subretinal fluid had regressed, but on the other hand, it was identified that PDT possibly resulted in the activation of two other previously quiescent PCV lesions. No other treatment was applied, and the patient's clinical status was monitored. A new evaluation after 6 weeks, revealed the complete resolution of the exudative phenomena and the significant improvement of vision. Three years later, the condition remains stable. Our report is the first in the literature to describe a case of PAEM following PDT with a small target spot (850 µm), while no other report has demonstrated that PCV-associated PAEM may resolve spontaneously without any treatment. Moreover, the application of PDT was accompanied by the activation of two previously inactive PCV lesions, an adverse effect that has not been previously described.