Photodynamic therapy for choroidal hemangioma associated with serous retinal detachment.
OBJECTIVE
To describe the clinical findings in 3 eyes with circumscribed choroidal hemangioma before and after treatment with photodynamic therapy.


METHODS
In the setting of a tertiary referral center, 2 patients with circumscribed, posteriorly located, choroidal hemangiomas (thicknesses 2.4 and 2.9 mm) contiguous with the superior boundary of the optic nerve and accompanied by serous detachments of the sensory retina extending into the macula were treated with photodynamic therapy using a Zeiss diode laser (692 nm) and a sensitizing dye, verteporfin. A third patient with a circumscribed subfoveal hemangioma (3.9 mm in thickness) and a prominent serous retinal detachment was similarly treated. The tumors were studied with ultrasonography and fluorescein angiography. Visual fields were tested with Goldmann perimetry at follow-up.


RESULTS
Following photodynamic therapy, the serous retinal detachments resolved, and the choroidal hemangioma in each of the 3 eyes regressed to a nonmeasurable thickness within 2 to 5 months. The visual acuity improved from 20/50 to 20/20, 20/150 to 20/20, and 3/200 to 20/200 in the respective cases. Two eyes were treated twice. The tumors have not recurred at follow-up visits from 11 to 16 months. Nerve fiber bundle field defects were not demonstrated with Goldmann field testing.


CONCLUSIONS
Photodynamic therapy seems to be effective in the management of circumscribed choroidal hemangioma. Following photodynamic therapy, the choroidal hemangiomas in 3 eyes were no longer measurable by ultrasonography, and the accompanying serous detachments resolved with improvement in the central visual acuities. Nerve fiber bundle defects were not identified.
Robertson
Dennis M
DM
Department of Ophthalmology, Mayo Clinic, Rochester, MN 55905, USA. robertson.dennis@mayo.edu
D000368:Aged; D002830:Choroid Neoplasms / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D005451:Fluorescein Angiography; D006391:Hemangioma / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010778:Photochemotherapy; D017319:Photosensitizing Agents / Q000627:therapeutic use*; D011166:Porphyrins / Q000627:therapeutic use*; D012163:Retinal Detachment / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D016896:Treatment Outcome; D000077362:Verteporfin; D014792:Visual Acuity; D058609:Visual Field Tests; D014794:Visual Fields
D017319:Photosensitizing Agents; D011166:Porphyrins; D000077362:Verteporfin