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Wasim A Samara, Chloe TL Khoo, Renelle Pointdujour Lim, George Magrath, Arman Mashayekhi, Jerry A Shields, Carol L Shields; Photodynamic Therapy for Symptomatic Choroidal Nevi in 23 Cases. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):3441.
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© ARVO (1962-2015); The Authors (2016-present)
To report the outcome of treatment of symptomatic choroidal nevi with photodynamic therapy (PDT).
Retrospective interventional case series of 23 eyes with symptomatic choroidal nevi, from subfoveal fluid or cystoid macular edema, treated with standard PDT.
Mean patient age was 52 years (range, 13-73 years). Mean tumor thickness and diameter were 2 mm (range, 0.8-3.4 mm) and 5 mm (range, 4.5-9 mm) respectively, and the mean tumor distance to foveola was 1 mm (range, 0-6 mm). 18 nevi (78%) were melanotic, 4 (17%) amelanotic, and 1 mixed. Mean number of PDT sessions was 1.4 (range, 1-2). Among the 19 patients (82%) who had subretinal fluid in fovea (SRF) before PDT, 12 (63%) showed resolution of SRF, which was complete in 6 patients and partial in the other 6. At mean follow-up of 46 months, 3 of 12 patients with prior SRF resolution developed recurrent SRF. Among the 5 patients who had cystoid macular edema (CME) before PDT treatment, 3 had CME resolution after PDT with one of these patients developing CME recurrence on subsequent follow-up. Of 18 patients with visual acuity of 20/40 or less before PDT, 6 (33%) had improved visual acuity, 8 (44%) had stable visual acuity and 4 (22%) had worse visual acuity following PDT. Retinal pigment epithelial atrophy at the site of PDT application developed in 1 patient, but no other complications related to PDT were noted. Two patients (9%) showed growth of nevus into choroidal melanoma and were treated with radioactive plaque and transpupillary thermotherapy.
PDT is a safe and effective treatment modality, leading to resolution of SRF and CME in about 60% of patients with symptomatic choroidal nevi.
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