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Marilette Stehouwer, Jan E Keunen, Reinier O Schlingemann, Frank D Verbraak; Results of Single spot limited PDT in patients with choroidal haemangioma. Invest. Ophthalmol. Vis. Sci. 2014;55(13):3096. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
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.
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.
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.
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.
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