title: Standard versus bolus photodynamic therapy in circumscribed choroidal hemangioma: functional outcomes.
abstract: OBJECTIVE
  To compare standard versus bolus photodynamic therapy (PDT) in the treatment of symptomatic circumscribed choroidal hemangioma (CCH).
  
  
  METHODS
  Twenty consecutive cases of CCH were included in this prospective randomized study. Each patient was randomly assigned to receive either standard PDT (10-minute 6 mg/mq2 verteporfin infusion; treatment at 15 min; 50 J/cm2; 83 s) or bolus PDT (6 mg/mq2 verteporfin infusion bolus in 1 min; treatment at 5 min; 100 J/cm2; 166 s). Best-corrected visual acuity (BCVA), fundus photography, optical coherence tomography, fluorescein, and indocyanine green angiography were performed at baseline and during follow-up. Retinal sensitivity was tested with microperimetry before and after treatment. Follow-up was longer than 32 months.
  
  
  RESULTS
  Mean follow-up was 58±11 months. All cases (100%) showed clinical regression of the treated lesion. Neuroretinal and retinal pigment epithelium (RPE) changes were found in 9 (90%) bolus PDT over treated area. No similar RPE changes were found in patients treated with standard PDT. There was a no statistically significant difference in BCVA outcome between the 2 groups (p=0.078). Microperimetry revealed reduced sensitivity over the treated area in 7 bolus PDT vs 1 in standard treated eyes (p=0.008).
  
  
  CONCLUSIONS
  Both standard and bolus PDT induce regression of symptomatic CCH. Bolus PDT may cause RPE and retinal changes associated with reduced retinal sensitivity.
authors.affiliation: Department of Ophthalmology, University of Padova, Padova, Italy.
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Pilotto
authors.forename: Francesca
authors.initials: F
authors.lastname: Urban
authors.forename: Raffaele
authors.initials: R
authors.lastname: Parrozzani
authors.forename: Edoardo
authors.initials: E
authors.lastname: Midena
mesh_terms: D000328:Adult; D000368:Aged; D002830:Choroid Neoplasms / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D004396:Coloring Agents; D005260:Female; D005451:Fluorescein Angiography; D005500:Follow-Up Studies; D006391:Hemangioma / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D007208:Indocyanine Green; D008297:Male; D008875:Middle Aged; D010778:Photochemotherapy; D017319:Photosensitizing Agents / Q000008:administration & dosage; D011166:Porphyrins / Q000008:administration & dosage; D011446:Prospective Studies; D012160:Retina / Q000502:physiology; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D000077362:Verteporfin; D014792:Visual Acuity / Q000502:physiology; D058609:Visual Field Tests; D014794:Visual Fields / Q000502:physiology
chemical_list: D004396:Coloring Agents; D017319:Photosensitizing Agents; D011166:Porphyrins; D000077362:Verteporfin; D007208:Indocyanine Green