Sturge-Weber syndrome: decrease in intraocular pressure after transpupillary thermotherapy for diffuse choroidal haemangioma.
OBJECTIVE
To report intraocular pressure (IOP) reduction after selective and partial destruction of diffuse choroidal haemangioma (DCH) by transpupillary thermotherapy (TTT) using an 810 nm infrared diode laser in two patients with Sturge-Weber syndrome (SWS) having late-onset juvenile glaucoma (LOJG).


METHODS
An interventional small case series. Laser spots (diameter, 1 mm) were applied to the tumour surface located outside the posterior pole. Energy level (600-1700 mW) and exposure time (1-4 seconds) were increased stepwise until the tumour exhibited a greyish discoloration. The treatment was split into 2-4 sessions.


RESULTS
Before TTT, both patients had uncontrolled LOJG with an IOP of 23 mmHg (Case 1) and 45 mmHg (Case 2) in spite of topical medications. In both cases, TTT led to normalization of IOP to 15 mmHg and 24 mmHg, respectively, and stopped the progression of LOJG during a follow-up period of 6 years (Case 1) and 1 year (Case 2). Visual loss or other complications were not observed.


CONCLUSIONS
Our study highlights the close link that exists between LOJG and DCH in SWS. A single treatment modality such as TTT may both reduce IOP in LOJG and help to prevent exudative retinal detachment in DCH. We believe that TTT is a good therapeutic option for SWS patients who have both DCH and LOJG.
Gambrelle
Joël
J
Department of Ophthalmology, Morvan Hospital, Brest, France. joel.gambrelle@hotmail.fr
Kivelä
Tero
T
Grange
Jean-Daniel
JD
D002830:Choroid Neoplasms / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D004396:Coloring Agents; D005260:Female; D005451:Fluorescein Angiography; D005901:Glaucoma / Q000503:physiopathology; D006391:Hemangioma / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D006979:Hyperthermia, Induced; D007208:Indocyanine Green; D007259:Infrared Rays; D007429:Intraocular Pressure / Q000502:physiology*; D053685:Laser Therapy; D054023:Lasers, Semiconductor; D008297:Male; D011680:Pupil; D012189:Retrospective Studies; D013341:Sturge-Weber Syndrome / Q000503:physiopathology / Q000628:therapy*; D055815:Young Adult
D004396:Coloring Agents; D007208:Indocyanine Green