Single spot PDT in patients with circumscribed choroidal haemangioma and near normal visual acuity.
BACKGROUND
In circumscribed choroidal hemangiomas (CCH) a long observation period and decreased visual acuity before treatment are risk factors for poor visual outcome. Therefore, we studied the use of limited, single spot photodynamic therapy (PDT) with Visudyne for the timely treatment of CCH.


METHODS
Six consecutive patients with CCH, and metamorphopsia but (near) normal visual acuity were treated with PDT, using a single spot covering only the most prominent part of the tumour, and a radiance exposure of 50 J/cm(2). Start of treatment was 6 min following a 1-min infusion with Visudyne (6 mg/m(2) BSA), using a diode laser (692 nm).


RESULTS
In all patients, the metamorphopsia disappeared, the OCT images returned to a normal foveal contour, and visual acuity remained 20/20 or improved to 20/20. In five patients, the tumour became ultrasonographically undetectable; in three after one PDT session, in one patient after two and in another patient after three PDT sessions. The last patient had a residual tumour height of 1.2 mm, but no metamorphopsia, a normal foveal contour on OCT, and fluorescein angiography showed no residual leakage.


CONCLUSIONS
The present series demonstrates that single spot PDT might be an effective treatment for CCH with a visual acuity > or =20/30, without serious side-effects during a follow-up of at least 18 months.
Verbraak
F D
FD
Laser Centre, Academic Medical Centre, Amsterdam, The Netherlands. f.d.verbraak@amc.uva.nl
Schlingemann
R O
RO
de Smet
M D
MD
Keunen
J E E
JE
D000328:Adult; D002830:Choroid Neoplasms / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D005260:Female; D005451:Fluorescein Angiography; D006391:Hemangioma / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010778:Photochemotherapy; D017319:Photosensitizing Agents / Q000627:therapeutic use*; D011166:Porphyrins / Q000627:therapeutic use*; D041623:Tomography, Optical Coherence; D000077362:Verteporfin; D014786:Vision Disorders / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology; D014792:Visual Acuity / Q000502:physiology*
D017319:Photosensitizing Agents; D011166:Porphyrins; D000077362:Verteporfin