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F.D. Verbraak, R.O. Schlingemann, J.E. Keunen, M.D. de Smet; Limited PDT for Choroidal Hemangioma . Invest. Ophthalmol. Vis. Sci. 2003;44(13):1586.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: To describe the use of limited Photodynamic Therapy (PDT) with Visudyne for the treatment of symptomatic choroidal hemangiomas Methods: Choroidal hemangiomas in 10 patients were treated with limited Photodynamic Therapy 6 minutes following a one minute infusion with Visudyne (6 mg / m2 BSA), using a diode laser (692 nm ) and a single spot size sufficient to cover only the most prominent part of the tumor. Exposure time was 166 seconds, in the first three patients, and reduced to 83 seconds, in the last seven patients, resulting in a radiance exposure of respectively 100 and 50 J / cm2. Results: In all seven patients without previous conventional treatment visual acuity improved following PDT treatment. In one patient, previously treated elsewhere with PDT according to the treatment protocol as used for subfoveal neovascularisations without success, the second PDT, according to the above mentioned settings proved to be successful with an increase in visual acuity. In the two remaining patients with prior radiation treatment both patients reported widening of the visual angle, and sharper vision, but did not show an increase in ETDRS vision. In all but three patients the tumor became ultrasonographically undetectable by the first follow-up visit at 6 weeks, with only a slight irregularity at the level of the previous tumor remaining. In one patient the tumor height was reduced to less then 1 mm, and in only two patients the residual tumor showed a height over 1mm. In all patients the retinal detachment disappeared, and the often present (cystoid) macular edema could not be visualized on fluorescein angiography. Conclusions: The present series demonstrates that even a limited - low radiance, single spot-photodynamic therapy with Visudyne is an effective first line treatment for choroidal hemangiomas. Seven patients with longstanding loss of visual acuity of 1 year or more showed an improvement of visual acuity following treatment, and in two patients with a vision loss of more then 10 years PDT treatment was still beneficial, but to a lesser extent. PDT with Visudyne can be considered as an effective first line treatment for all patients with a choroidal hemangioma.
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