Abstract
Purpose:
To report the outcome of treatment of symptomatic choroidal nevi with photodynamic therapy (PDT).
Methods:
Retrospective interventional case series of 23 eyes with symptomatic choroidal nevi, from subfoveal fluid or cystoid macular edema, treated with standard PDT.
Results:
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.
Conclusions:
PDT is a safe and effective treatment modality, leading to resolution of SRF and CME in about 60% of patients with symptomatic choroidal nevi.