Abstract
Purpose:
To study the long term outcome of patients with a circumscribed choroidal hemangioma (CCH) treated with a single spot limited photodynamic therapy (PDT) with Visudyne.
Methods:
Twenty patients with a CCH were treated between 2001 and 2010 with a single spot limited PDT for CCH. The single spot covered only the most prominent part of the tumour, using a standard diode laser (692 nm), with a radiance exposure of 50 J/cm2, starting 6 min after a 1-min infusion with Visudyne (6 mg/m2 BSA). In a retrospective design the long term outcome was evaluated. Outcome parameters were: change in visual acuity (VA) pre,- and post PDT, presence of regression of the tumour on ultrasound (USG), presence and change of leakage on OCT.
Results:
Regression of the tumour was seen in all patients with USG during follow up (mean follow-up 17.7 months, range 3 to 36 months). In 12 patients, the tumour became undetectable on ultrasound examination. The VA pre-PDT varied from 20/400 to 20/20, and was less than 20/40 in 10 patients. After treatment in only 5 patients VA remained below 20/40. Overall, Improvement of VA to 20/25 or higher was seen in 14 patients. In all patients, retinal leakage on OCT disappeared following PDT. Three patients had a recurrence of the CCH with retinal leakage, 4.5 , 3 and 9.3 years after PDT treatment. In all of them the tumour was still detectable after the first PDT. After retreatment with limited PDT, 2 patients recovered with a VA of 20/20, the other patient showed regression of the tumour but without improvement of VA (20/800). In the 17 patients without recurrence of leakage all parameters remained stable during follow-up.
Conclusions:
Circumscribed choroidal hemangioma is effectively treated with a single spot limited photodynamic therapy with improvement of VA in the majority of cases. A recurrence can be seen especially when the tumour is not completely regressed after initial PDT.
Keywords: 744 tumors •
452 choroid •
647 photodynamic therapy