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Giulia Midena, Monica M Pagliara, maria grazia sammarco, Andrea Scupola, Martina Maceroni, Carmela Grazia Caputo, Maria Antonietta Blasi; Photodynamic therapy for the treatment of choroidal metastasis: a retrospective study. Invest. Ophthalmol. Vis. Sci. 2019;60(9):3551.
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© ARVO (1962-2015); The Authors (2016-present)
To report the clinical and ultrasonographic outcome of photodynamic therapy (PDT) used as local treatment of choroidal metastasis.
Twenty-three tumors of 20 eyes (16 patients) affected by choroidal metastasis, already under treatment with systemic chemotherapy, were included in this retrospective study. Each patient underwent at baseline: full ophthalmologic examination including Spectral Domain-OCT (SD-OCT) and A-scan and B-scan ultrasonography. Each metastatic tumor was treated with PDT in a standard fashion. Adjunctive PDT sessions were used if metastasis was not completely flattened. Response to PDT was confirmed by tumor control and best-corrected visual acuity. Median follow-up was 4 months (range 1-9).
Choroidal involvement was unilateral in 12 patients (75%) and bilateral in 4 patients (25%). Metastasis were single in 18 eyes (90%) and multiple in 2 eyes (10%); all tumors were highly vascularized, and hypopigmented. Eighteen tumors were located close to the macula. Mean tumor thickness, measured with ultrasonography, was 3.85mm (range 2.17-5.6mm). All 23 tumors were associated with subretinal fluid. After PDT 17 eyes had stabilization or improvement of best-corrected visual acuity, and resolution of subretinal fluid was achieved in 13 tumors. The mean decrease in tumor thickness, achieved in 18 tumors, was 0.5mm. An increase in thickness was observed in 5 tumors of 2 patients with aggressive multi metastatic disease, not responding to systemic chemoteraphy. No difference was observed according to the primary histologic type.
PDT may be an effective local treatement for choroidal metastasis, mainly In patients with limited survival. PDT improves functional outcome in a shorter time than systemic chemotherapy and it may allow treatment of choroidal metastatic tumors close to critical structures such as the macula.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.
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