title: Photodynamic therapy for symptomatic choroidal hemangioma: visual and anatomic results.
abstract: OBJECTIVE
  To document the anatomic and functional outcome of photodynamic therapy (PDT) in symptomatic choroidal hemangioma
  
  
  METHODS
  Prospective, noncomparative, interventional case series.
  
  
  METHODS
  Fifteen patients with circumscribed choroidal hemangioma of the posterior pole presenting with progressive vision loss caused by exudation into the macular area.
  
  
  METHODS
  PDT using 6 mg/m(2) body surface area verteporfin and a light dose of 100 J/cm(2) at 692 nm was performed. One to four treatments with a single laser spot were applied in 6-week intervals. A standardized evaluation was provided before and at 6-week intervals after each treatment, at 3, 6, and 12 months, and a mean follow-up 19 months after the last application.
  
  
  METHODS
  Functional tests included best-refracted visual acuity (Early Treatment of Diabetic Retinopathy Study criteria) and scanning laser scotometry. Anatomic results were documented by ophthalmoscopy, fluorescein/indocyanine green angiography, and ultrasonography.
  
  
  RESULTS
  A complete regression of the vascular mass was achieved in all eyes after the last course of one to four consecutive treatments. Tumors (mean height, 3.8 mm) responded with a reproducible decrease in size to each treatment, with the most intensive effect seen after the first application. Progressive occlusion of the angiomatous net without recanalization was documented angiographically. Two patients had stable vision with resolution of metamorphopsia; 13 patients demonstrated visual recovery. An overall visual acuity (VA) improvement of an average of 3 lines was documented, with a mean VA level of 20/125 before treatment and 20/80 after therapy. Visual fields showed withdrawal of central scotomas from the macula. No recurrence was seen during a follow-up for up to 50 months.
  
  
  CONCLUSIONS
  PDT using verteporfin offers a safe and effective option to treat choroidal hemangiomas. Complete anatomic regression with persistent absence of leakage is associated with substantial improvements in vision.
authors.affiliation: University Eye Hospital, Luebeck, Germany.
authors.forename: Ursula M
authors.initials: UM
authors.lastname: Schmidt-Erfurth
authors.forename: Stephan
authors.initials: S
authors.lastname: Michels
authors.forename: Christine
authors.initials: C
authors.lastname: Kusserow
authors.forename: Bernhard
authors.initials: B
authors.lastname: Jurklies
authors.forename: Albert J
authors.initials: AJ
authors.lastname: Augustin
mesh_terms: D000328:Adult; D000368:Aged; D002830:Choroid Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy*; D004396:Coloring Agents; D005451:Fluorescein Angiography; D018324:Hemangioma, Capillary / Q000000981:diagnostic imaging / Q000188:drug therapy*; D006801:Humans; D007208:Indocyanine Green; D008875:Middle Aged; D010778:Photochemotherapy; D017319:Photosensitizing Agents / Q000627:therapeutic use*; D011166:Porphyrins / Q000627:therapeutic use*; D011446:Prospective Studies; D012449:Safety; D014463:Ultrasonography; D000077362:Verteporfin; D014792:Visual Acuity; D014794:Visual Fields
chemical_list: D004396:Coloring Agents; D017319:Photosensitizing Agents; D011166:Porphyrins; D000077362:Verteporfin; D007208:Indocyanine Green