Abstract
Purpose: :
It has been shown that Photodynamic Therapy (PDT) with Verteporfin is an efficient and save therapeutic option in the treatment of choroidal hemangiomas. Nevertheless, juxtapapillary choroidal hemangiomas (JCH) pose a therapeutic dilemma, since severe adverse events have been demonstrated in cases in which the optic disc was included in the treatment spot. The aim of this investigation was to evaluate a new way of application of the laser–spot during PDT in order to avoid side effects on the optic disc.
Methods: :
The outcome in 11 eyes of 11 patients with JCH after PDT was evaluated regarding visual acuity (VA), tumor thickness and side effects. The light application was performed in a " paintbrush " fashion, by moving the laser spot with a constant speed over the entire tumor surface. This allowed a confluent PDT of the whole tumor without treating the optic disc.
Results: :
During the mean follow–up of 11,6 (3–24) months, all tumors showed a regression of the thickness. The mean tumor thickness before PDT was 3,2 (2.7–6.3) mm and 2.1 (0.9–3.3) mm at the last follow–up. VA improved = > 1 line in 7/11 eyes, 5/11 eyes had an improvement of = > 3 lines and the remaining 3 eyes showed unchanged VA. Vision threatening side effects could not be observed.
Conclusions: :
The new PDT "paintbrush" treatment technique allowed a favorable tumor regression in all treated patients combined with an improvement of VA in the majority of cases (7/11) in juxtapapillary choroidal hemangiomas without treating the optic disc.
Keywords: photodynamic therapy • tumors • optic disc