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R. Sachdeva, H. Dadgostar, P. K. Kaiser, J. E. Sears, A. D. Singh; Verteporfin Photodynamic Therapy of Retinal Capillary Hemangioma. Invest. Ophthalmol. Vis. Sci. 2009;50(13):5231.
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To evaluate the efficacy of verteporfin (Visudyne) photodynamic therapy of retinal capillary hemangioma.
Following a period of observation, all 5 eyes received 1-3 courses of standard verteporfin photodynamic therapy (VPDT) upon development of vision-threatening complications of hemangioma. Standard therapy consisted of administration of intravenous verteporfin (6mg/m2 body surface area) followed by VPDT with a Diode laser (689/690 nm) with an intensity of 600mW/cm2 for exposure of 83 seconds (50 J/cm2). Follow up included documentation of best-corrected Snellen visual acuity (BCVA), tumor regression, and presence of SRF as measured by dilated fundus examination, fundus photos, and optical coherence tomography (OCT) readings. These parameters were documented at one week, one month, and three months following each VPDT session and continues to date (up to 18 months following first VPDT).
BCVA improved or stabilized in 4 eyes. All eyes showed favorable response to VPDT with tumor regression or stabilization as well as resolution of SRF. Three eyes required VPDT retreatment for recurrent SRF. Additionally, epiretinal membrane and TRD worsened in three eyes, requiring vitreoretinal surgery. Vaso-occlusive effects, as previously reported, were not observed in this case series.
VPDT is an important treatment modality for retinal capillary hemangioma. It is effective in tumor regression as well as resolution of SRF, leading to stabilization or improvement of visual acuity. Resultant visual acuity may be compromised by recurrence of SRF or tumor fibrosis leading to worsening vitreal macular traction and TRD. While this case series shows promising results, a larger study is necessary to validate these findings.This work was supported by a Research to Prevent Blindness Challenge Grant, Department of Ophthalmology, Cleveland Clinic Lerner College of Medicine.
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