Choroidal haemangioma and photodynamic therapy. Anatomical and functional response of patients with choroidal hemangioma treated with photodynamic therapy

Abstract

Abstract Objective To study the effectiveness and limitations of photodynamic therapy (PDT) as treatment of choice in patients with symptomatic circumscribed choroidal hemangioma. Methods A retrospective study was conducted on 16 patients (13 men and 3 women, with mean age of 54.88 years) with circumscribed choroidal hemangioma, who attended our center and were treated with PDT in the last 7 years. Results All patients had circumscribed choroidal hemangioma, which caused a decrease in visual acuity (VA) secondary to the presence of intraretinal microcystic edema or neurosensory detachment. The mean initial VA was 0.23, and the final mean VA after performing PDT was 0.38 (all the VA were measured in decimal scale). It should be noted that patients needed a mean of 1.69 PDT sessions. Three of the patients needed rescue treatment with trans-pupillary thermotherapy, intravitreal injection of anti-vascular endothelial growth factor (ranibizumab, aflibercept) or a dexamethasone intravitreal implant (Ozurdex ® ). The indication for a change of treatment was the persistence of intraretinal microcystic edema and/or neurosensory detachment (or incomplete resolution) after 3 PDT sessions. As overall results, 62.5% of patients evolved into anatomical and functional (increase in AV or stability) resolution. Conclusions PDT is a straight forward and fast procedure, with a good anatomical and functional response, causing minimal damage to adjacent vessels.