Work

Long-Term retrospective analysis of retinal pigment epithelium atrophy and secondary hyperplasia following verteporfin photodynamic therapy

Year: 2025

Type: article

Abstract: PURPOSE: To identify risk factors for retinal pigment epithelium (RPE) atrophy associated with verteporfin photodynamic therapy (PDT), with or without secondary RPE hyperplasia, and to evaluate long-term visual outcomes. MATERIALS AND METHODS: This retrospective study analyzed 197 eyes of 180 patients who underwent verteporfin PDT between 2000 and 2023. Baseline demographic and clinical characteristics were evaluated. RESULTS: Among 197 eyes that underwent one or more sessions of PDT, PDT-induced RPE atrophy was observed in 2 eyes (2.4 %) with wet age-related macular degeneration (wet AMD) or polypoidal choroidal vasculopathy (PCV) and in 1 eye (3.8 %) with central serous chorioretinopathy (CSC). In contrast, 18 eyes (22.2 %) with myopic choroidal neovascularization (mCNV) developed PDT-induced RPE atrophy. Subgroup analysis revealed that in the mCNV group, patients with PDT-induced RPE atrophy were significantly younger (36.5 ± 13.7 years vs. 46.3 ± 12.8 years; P < 0.001) and underwent more PDT sessions (2.6 ± 1.8 vs. 1.5 ± 0.8; P < 0.001) than those without atrophy. Five patients developed secondary RPE hyperplasia, all from the mCNV group. CONCLUSION: Verteporfin PDT rarely induces RPE atrophy in patients with wet AMD, PCV, and CSC. However, in patients with myopic CNV, PDT may occasionally cause alterations in the RPE, including both atrophy and secondary hyperplasia. While PDT-induced RPE atrophy was not a statistically significant predictor of best-corrected visual acuity at the final follow-up in the mCNV and wet AMD/PCV groups in the linear regression analysis, it was a significant factor in the CSC group.

Source: Photodiagnosis and Photodynamic Therapy

DOI: 10.1016/j.pdpdt.2025.104576