Polypoidal choroidal vasculopathy following photodynamic therapy for choroidal hemangioma.
OBJECTIVE
To report a case of circumscribed choroidal hemangioma (CCH) that responded to photodynamic therapy (PDT) but 3 years later developed polypoidal choroidal vasculopathy (PCV) with exudative retinopathy.


METHODS
Case report.


RESULTS
A 59-year-old woman with a juxtapapillary CCH in her left eye was treated with a single 83-second, 7.5 mm PDT laser spot at 689 nm (50 J/cm2) 15 minutes after the injection of intravenous verteporfin (6 mg/m2). Three years later, the patient presented with photopsia in her left eye. Fundus examination of the left eye showed CCH regressed completely to a flat atrophic scar. There was diffuse macular edema and exudative retinopathy along the inferotemporal vascular arcade. On indocyanine green angiography, there were hyperfluorescent dilated choroidal vessels inferior to the foveola with late staining and leakage consistent with PCV. Hypofluorescence superior and nasal to the optic disc at the site of the treated hemangioma, consistent with choroidal ischemia, was observed. She was treated with 1.25 mg (0.05 cc) intravitreal bevacizumab. After 21 months of follow-up, the exudative retinopathy and macular edema completely regressed.


CONCLUSIONS
PDT is an effective treatment for CCH. Side effects of PDT for CCH are rare but include PCV.
Tuncer
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Ocular Oncology Service, Wills Eye Institute, Thomas Jefferson University, Philadelphia, PA 19107, USA.
Demirci
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D020533:Angiogenesis Inhibitors / Q000627:therapeutic use; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D061067:Antibodies, Monoclonal, Humanized; D000068258:Bevacizumab; D002829:Choroid / Q000098:blood supply*; D015862:Choroid Diseases / Q000139:chemically induced* / Q000175:diagnosis / Q000188:drug therapy; D002830:Choroid Neoplasms / Q000188:drug therapy*; D004396:Coloring Agents; D005260:Female; D005451:Fluorescein Angiography; D006391:Hemangioma / Q000188:drug therapy*; D006801:Humans; D007208:Indocyanine Green; D007511:Ischemia / Q000139:chemically induced / Q000175:diagnosis / Q000188:drug therapy; D008269:Macular Edema / Q000139:chemically induced / Q000175:diagnosis / Q000188:drug therapy; D008875:Middle Aged; D016491:Peripheral Vascular Diseases / Q000139:chemically induced* / Q000175:diagnosis / Q000188:drug therapy; D010778:Photochemotherapy / Q000009:adverse effects*; D017319:Photosensitizing Agents / Q000009:adverse effects; D011166:Porphyrins / Q000009:adverse effects; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors; D000077362:Verteporfin
D020533:Angiogenesis Inhibitors; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D004396:Coloring Agents; D017319:Photosensitizing Agents; D011166:Porphyrins; D042461:Vascular Endothelial Growth Factor A; D000077362:Verteporfin; D000068258:Bevacizumab; D007208:Indocyanine Green