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R. Muller-Velten, S. Michels, U. Schmidt-Erfurth; Photodynamic Therapy in Choroidal Hemangioma: A Three Year Follow-Up . Invest. Ophthalmol. Vis. Sci. 2003;44(13):1588.
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Purpose:To document the long-term follow-up of anatomical and functional outcome in patients with choroidal hemangioma treated with Photodynamic Therapy (PDT) Methods:14 consecutive patients were included in a prospective interventional case series. PDT using 6mg/m² body surface area Verteporfin as a bolus and a light dose of 100J/cm² at 692nm was performed. Up to 4 laser treatments were applied with a single spot. The retreatment interval was 6 weeks. A standardized evaluation was performed 6 weeks after each treatment, every three months within the first year and once per year during further follow-up. Functional tests included best refracted ETDRS VA and scanning laser scotometry. Anatomical results were documented by ophthalmoscopy, fluorescein (FA)/ indocyanine green angiography (ICGA) and ultrasound. Results:At baseline, all patients presented with symptomatic, exudative choroidal hemangioma of the posterior pole associated with significant vision loss ranging from 20/30 to 20/800. During a mean follow-up of 36 months (14 to 65 months) no patient showed any sign of recurrence. In all patients a complete and permanent regression of the tumor mass was documented by ophthalmoscopy, angiography and ultrasound. 12 of 14 patients showed a substantial increase in visual acuity ranging from 1 to 8 lines, two patients remained stable. No reduction of visual function was noted in any of the treated patients. Metamorphopsia and central visual field scotomas resolved in all patients and did not recur during the entire follow-up. In addition, no unwanted side-effects were detectable. There was no change within the anterior segment including an absence of lens opacification. The treated area showed various levels of chorioretinal atrophy post-treatment which did not enlarge. The fovea remained intact without any exudative change or alteration of the retinal pigment epithelium. Retinal vessels were intact and well perfused, no vascular atrophy, ischemia or reactive neovascular growth was noted. Conclusions: PDT is currently the most promising treatment modality for patients with progressive choroidal hemangioma. The long-term control for up to 5 years showed persistent and complete anatomical absence of the tumor associated with stable improvement in visual acuity and central visual fields.
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