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J. Wachtlin, M. Spyridaki, N.E. Bechrakis, M.H. Foerster; A New "Paintbrush" Treatment Technique of Juxtapapillary Choroidal Hemangiomas With Photodynamic Therapy (PDT) . Invest. Ophthalmol. Vis. Sci. 2006;47(13):4714.
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It has been shown that Photodynamic Therapy (PDT) with Verteporfin is an efficient and save therapeutic option in the treatment of choroidal hemangiomas. Nevertheless, juxtapapillary choroidal hemangiomas (JCH) pose a therapeutic dilemma, since severe adverse events have been demonstrated in cases in which the optic disc was included in the treatment spot. The aim of this investigation was to evaluate a new way of application of the laser–spot during PDT in order to avoid side effects on the optic disc.
The outcome in 11 eyes of 11 patients with JCH after PDT was evaluated regarding visual acuity (VA), tumor thickness and side effects. The light application was performed in a " paintbrush " fashion, by moving the laser spot with a constant speed over the entire tumor surface. This allowed a confluent PDT of the whole tumor without treating the optic disc.
During the mean follow–up of 11,6 (3–24) months, all tumors showed a regression of the thickness. The mean tumor thickness before PDT was 3,2 (2.7–6.3) mm and 2.1 (0.9–3.3) mm at the last follow–up. VA improved = > 1 line in 7/11 eyes, 5/11 eyes had an improvement of = > 3 lines and the remaining 3 eyes showed unchanged VA. Vision threatening side effects could not be observed.
The new PDT "paintbrush" treatment technique allowed a favorable tumor regression in all treated patients combined with an improvement of VA in the majority of cases (7/11) in juxtapapillary choroidal hemangiomas without treating the optic disc.
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