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Robert Beardsley, Tara A. McCannel; Recurrent Leakage after Visudyne Photodynamic Therapy for the Treatment of Circumscribed Choroidal Hemangioma. Invest. Ophthalmol. Vis. Sci. 2012;53(14):4937.
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© ARVO (1962-2015); The Authors (2016-present)
To report on the recurrence of serous retinal detachment following verteporfin photodynamic therapy of symptomatic circumscribed choroidal hemangioma.
A single center, retrospective chart review was performed for all patients with circumscribed choroidal hemangioma (CCH) treated with Visudyne (verteporfin injection, QLT Ophthalmics, Menlo Park, CA) photodynamic therapy (PDT). Initial and post-treatment visual acuity, ultrasound and ocular coherence tomography were evaluated. The requirement for subsequent treatments was also evaluated, including post-retreatment visual acuity, ultrasound and ocular coherence tomography.
Four patients who were treated with PDT for symptomatic serous retinal detachment secondary to CCH were managed for recurrent leakage and followed for an average of 47.5 months. Initial best-corrected visual acuity (BCVA) was logMAR 0.15 (20/25). Two patients required three re-treatments and two required four re-treatments for recurrent leakage. Average initial time to re-treatment was 23.4 months, with successive re-treatment intervals decreasing to 13 months, then 9.5 months, and finally 3.5 months. Final BCVA was logMAR 0.22 (20/30).
Although Visudyne PDT appears to be a successful initial treatment modality for CCH with symptomatic serous retinal detachment, leakage may recur. Patients requiring multiple re-treatments may experience recurrent leakage at more frequent intervals, and require higher doses of treatment to achieve visual improvement. These data suggest a resistance to treatment in CCH patients with long-term follow-up.
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