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L. Harris, T.M. Aaberg, Sr, T.M. Aaberg, Jr, J.E. Thordsen, D.F. Martin; Peripheral Retinal Capillary Hemangiomas Treated With Verteporfin and PhotodynamicTherapy . Invest. Ophthalmol. Vis. Sci. 2005;46(13):3466.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: To report efficacy of treating peripheral retinal capillary hemangiomas (RCHs) with verteporfin and photodynamic therapy (PDT). Methods: A retrospective, case series of 7 eyes of 7 consecutive patients with newly diagnosed, solitary, peripheral RCHs treated with verteporfin and PDT. Standard verteporfin dosages (6 mg/m2 of body surface area) were given. Standard and modified PDT protocols were followed. Modified PDT protocols involved shorter verteporfin infusion time of five minutes and the use of overlapping spots for a total of 166 seconds covering the entire lesion. Main outcome measures were angioma fibrosis and visual acuity. Results:Seven eyes of 7 patients with newly diagnosed, solitary, peripheral RCHs associated with exudative detachments were treated with verteporfin and PDT. Four patients had isolated angiomas, 2 had angiomas associated with von Hippel Lindau (VHL), and 1 had a reactive angioma. Preoperative visual acuity for the isolated angiomas was 20/400, 20/80, 20/40, 20/100. Postoperative visual acuity for the isolated angiomas was 20/60, 20/60, 20/25, 20/30 respectively. Preoperative visual acuity for the VHL angiomas was 20/50, 20/25. Postoperative visual acuity for the VHL angiomas was 20/25, 20/25 respectively. Preoperative and postoperative visual acuity for the reactive angioma was CF. Six patients achieved fibrosis of the angioma after PDT. One patient had additional cryotherapy and an intravitreal triamcinolone injection with subsequent angioma fibrosis. The patient with the reactive angioma developed a choroidal neovascularization (CNV) that broke through the retina and was attached to the posterior hyaloid at the fovea. Pars plana vitrectomy was performed to relieve the traction from the posterior hyaloid on the CNV, followed by repeat PDT of the angioma, achieving fibrosis. The patient's visual acuity remained CF. Two patients had tractional detachments that spontaneously separated. Four modified PDTs were performed. Three patients initially received the standard protocol, followed by a modified protocol to achieve fibrosis. One patient's only PDT followed a modified protocol, achieving fibrosis. The average number of PDTs performed per patient was 1.7. Mean followup was 11.3 months (range 4–24 months). Conclusions: Verteporfin with PDT was effective in achieving fibrosis in most of the angiomas. Visual acuity in 5 patients improved; visual acuity in 2 patients remained the same. Verteporfin with PDT is a viable treatment for peripheral RCHs.
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