Transient Increased Exudation after Photodynamic Therapy of Intraocular Tumors
An asymptomatic 61-year-old female with a 1.5 mm juxtapapillary retinal hemangioblastoma OD showed progressive retinal edema despite three prior off-label intravitreal bevacizumab injections (1.5 mg) [Figures and ]. PDT was delivered to the tumor, followed immediately by a fourth intravitreal bevacizumab injection (1.5 mg). One day after the procedure, the patient presented with a complaint of blurred vision. On examination, the best corrected visual acuity (BCVA) had decreased from 20/20 preoperatively to 20/70. Optical coherence tomography (OCT) showed extension of retinal edema into fovea []. There was spontaneous recovery of BCVA to 20/25 and complete resolution of macular edema 3 weeks after PDT []. Eight months after PDT BCVA was 20/20 but the patient complained of a persistent paracentral ring of haziness. The tumor remained stable with no recurrent intra- or subretinal fluid during subsequent follow-up of 3 years.