title: Benefits and complications of photodynamic therapy of papillary capillary hemangiomas.
abstract: OBJECTIVE
  To evaluate the potential benefit and risks of photodynamic therapy (PDT) in the treatment of papillary capillary hemangioma.
  
  
  METHODS
  Prospective, noncomparative, interventional case series.
  
  
  METHODS
  Five patients with solitary capillary hemangioma on the temporal portion of the optic nerve presenting with exudative decompensation and decrease in visual acuity (VA).
  
  
  METHODS
  All eyes received a standardized PDT treatment with 6 mg/kg body surface area verteporfin and application of 100 J/cm(2) light at 692 nm. One to three PDT courses were performed until resolution of exudation was achieved. A continuous follow-up was provided with documentation 1 week before and at 4 to 6 weeks, 3 months, and 12 months after the last treatment application.
  
  
  METHODS
  Functional parameters included best-refracted VA (Early Treatment Diabetic Retinopathy Study), and central scanning laser ophthalmoscope (SLO) scotometry and peripheral (automated perimetry) visual fields; anatomic parameters were presence of retinal edema or serous detachment (ophthalmoscopy) and tumor size (ultrasonography).
  
  
  RESULTS
  Pretreatment VA levels ranged from 20/40 to 20/800; posttreatment levels ranged from 20/64 to 20/2000. Tumor regression with resolution of macular exudate and serous retinal detachment was obtained in all eyes. A decline in VA of 1, 3, and 10 lines, respectively, was documented in three patients. Complications included transient decompensation of vascular permeability, occlusion of retinal vessels, and ischemia of the optic nerve.
  
  
  CONCLUSIONS
  PDT is successful in reducing tumor size and exudative activity. Vaso-occlusive effects at the level of the retina and optic nerve compromise the functional benefit. Parameters proven safe in choroidal neovascularization may be inappropriate in retinal capillary lesions of the optic nerve.
authors.affiliation: Department of Ophthalmology, the University Eye Hospital, Ratzeburger Allee 160, 23538 Lübeck, Germany.
authors.forename: Ursula M
authors.initials: UM
authors.lastname: Schmidt-Erfurth
authors.forename: Christine
authors.initials: C
authors.lastname: Kusserow
authors.forename: Irene A
authors.initials: IA
authors.lastname: Barbazetto
authors.forename: Horst
authors.initials: H
authors.lastname: Laqua
mesh_terms: D000328:Adult; D002199:Capillary Permeability / Q000187:drug effects; D005260:Female; D005451:Fluorescein Angiography; D005654:Fundus Oculi; D018324:Hemangioma, Capillary / Q000188:drug therapy* / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009887:Ophthalmoscopy; D009898:Optic Disk / Q000098:blood supply*; D019574:Optic Nerve Neoplasms / Q000188:drug therapy* / Q000473:pathology; D018917:Optic Neuropathy, Ischemic / Q000139:chemically induced; D010778:Photochemotherapy / Q000009:adverse effects; D017319:Photosensitizing Agents / Q000009:adverse effects / Q000627:therapeutic use*; D011166:Porphyrins / Q000009:adverse effects / Q000627:therapeutic use*; D011446:Prospective Studies; D015356:Retinal Artery Occlusion / Q000139:chemically induced; D012170:Retinal Vein Occlusion / Q000139:chemically induced; D000077362:Verteporfin; D014792:Visual Acuity; D014794:Visual Fields
chemical_list: D017319:Photosensitizing Agents; D011166:Porphyrins; D000077362:Verteporfin