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E. Balestrazzi, A. C. Tiberti, A. Scupola, M. Sammarco, E. Colangelo, M. A. Blasi; Photodynamic Therapy for Choroidal Hemangioma. Long Term Results. Invest. Ophthalmol. Vis. Sci. 2008;49(13):5688.
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To describe the long-term results of a prospective interventional case series of patients in order to provide the necessary evidence for defining the precise role of verteporfin PDT in the treatment of Circumscribed Choroidal Hemangiomas (CCH).
A prospective, nonrandomized interventional case series was conducted in twenty-two consecutive patients with symptomatic circumscribed choroidal haemengioma (CCH).PDT was performed using a radiant exposure of 50 J/cm2 over an interval of 83 seconds for the first three patients, and 100 J/cm2 at an irradiance of 600 mW/ cm2 over an interval of 166 seconds for all the other patients.All patients underwent a complete ophthalmic evaluation one week before PDT application and follow-up visits were scheduled at one, three months and every six months after treatment. Standardized VA measurements using the Early Treatment of Diabetic Retinopathy Study (ETDRS) charts at 4 m. Tumor thickness data were obtained by standardized A-scan and B scan ultrasonography . FA and ICG-A were performed using a fundus camera on a digital system.
Nineteen patients received only one PDT session at 100 J/cm2 and no recurrence was evidenced. PDT treatment was well tolerated in all patients without any side effect. Following PDT treatment with 100 J/cm2 all tumors showed a marked reduction in thickness and in associated exudative changes. At sixth month follow-up follow-up VA was improved on average of 7.8 ETDRS letters (mean VA: 45 ETDRS letters), and remained stabile for the whole length of follow-up period. Ultrasound examination showed a remarkable reduction of tumor height in all cases. FA evidenced rarefaction of the tumor vascularization and a reduction of leakage from the lesion, ICGA showed a decreased perfusion of the vascular channels. OCT disclosed resolution of macular oedema and reabsorption of subretinal fluid in all cases (100%).
All patients have shown an excellent response to PDT, with rapid reabsorption of subretinal fluid, flattening of hemangioma.VA was improved on average of 7.8 ETDRS letters. None of the patients developed retinal damage, focal choroidal ischemia or atrophy, or visual field defects. Choroidal ischemia and atrophy have been reported after three or more sessions of PDT. In this study OCT has appeared to be useful in evaluating the response to PDT providing objective measurements of intraretinal and subretilal fluid accumulation.
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