title: Three cases of large retinal capillary hemangiomas treated with verteporfin and photodynamic therapy.
abstract: OBJECTIVE
  To investigate the efficacy of verteporfin and photodynamic therapy in the treatment of large retinal capillary hemangiomas.
  
  
  METHODS
  Case reports of 3 patients with large retinal capillary hemangiomas treated with photodynamic therapy using verteporfin. Standard verteporfin dosages (6 mg/m(2) of body surface area) were given. Both standard and modified photodynamic protocols were followed. Modified protocols included shorter verteporfin infusion times and longer light exposure times.
  
  
  RESULTS
  Pretreatment best-corrected Snellen visual acuity of the 3 affected eyes were 20/100, 20/50, and 2/200, respectively. All cases had associated exudative retinal detachments involving the macula. Cases 1 and 2 were classic endophytic retinal capillary hemangiomas. Case 3 was a reactive retinal capillary hemangioma. Case 1 had 2 photodynamic therapy treatments, and after 8 months, visual acuity improved to 20/40. Two years after initiating photodynamic therapy, the visual acuity was 20/30 and there was no reperfusion of the hemangioma. Case 2 had 3 photodynamic therapy treatments. The hemangioma was fibrotic, and 20 months after initiating photodynamic therapy visual acuity improved to 20/30. Case 3 had 1 treatment, 11 weeks later and visual acuity improved to 20/400. Four months after treatment, visual acuity returned to counting fingers because of tractional elevation of the macula as the capillary hemangioma fibrosed. Vitrectomy surgery was performed, and choroidal and retinal neovascularization was discovered. Three months after vitrectomy visual acuity was 20/400. In cases 1 and 2, the capillary hemangioma ultimately regressed, and the exudative detachment resolved.
  
  
  CONCLUSIONS
  Verteporfin and photodynamic therapy were effective in achieving closure of large retinal capillary hemangiomas. In all cases, the hemangioma underwent fibrosis with consequent macular puckering due to retinal traction. In all cases, the visual acuity improved.
authors.affiliation: Associated Retinal Consultants, Grand Rapids, Mich, 49546, USA. aaberg3@comcast.net
authors.forename: Thomas M
authors.initials: TM
authors.lastname: Aaberg
authors.forename: Thomas M
authors.initials: TM
authors.lastname: Aaberg
authors.forename: Daniel F
authors.initials: DF
authors.lastname: Martin
authors.forename: James P
authors.initials: JP
authors.lastname: Gilman
authors.forename: Robert
authors.initials: R
authors.lastname: Myles
mesh_terms: D000293:Adolescent; D000328:Adult; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D002648:Child; D005260:Female; D005355:Fibrosis; D018324:Hemangioma, Capillary / Q000188:drug therapy* / Q000473:pathology; D006801:Humans; D008297:Male; D010778:Photochemotherapy; D017319:Photosensitizing Agents / Q000627:therapeutic use*; D011166:Porphyrins / Q000627:therapeutic use*; D019572:Retinal Neoplasms / Q000188:drug therapy* / Q000473:pathology; D012171:Retinal Vessels / Q000187:drug effects / Q000473:pathology; D016896:Treatment Outcome; D000077362:Verteporfin; D014792:Visual Acuity; D014821:Vitrectomy
chemical_list: D000970:Antineoplastic Agents; D017319:Photosensitizing Agents; D011166:Porphyrins; D000077362:Verteporfin