Photodynamic Therapy for Choroidal Metastasis

Abstract

To evaluate the effectiveness of photodynamic therapy (PDT) in the management of choroidal metastasis. Retrospective, interventional case series. Patients with choroidal metastasis treated with PDT at a single institution were reviewed. PDT was applied with verteporfin at a dose of 6 mg/m(2) body surface area and a 689 nm diode laser for 83 seconds. Visual acuity, tumor basal diameter, tumor thickness by ultrasonography, and enhanced depth imaging optical coherence tomography (EDI-OCT), as well as associated features including subretinal fluid, were recorded before PDT and during follow-up examinations. Twenty-one tumors in 13 eyes of 10 patients were included. Eight tumors were treated with a single session of PDT, 11 tumors received 2 sessions, 1 tumor received 3 sessions, and 1 tumor received 5 sessions. At the end of a mean follow-up of 12 months (range, 3-42 months), 9 eyes (69%) had stable or improved visual acuity, while 4 eyes (31%) had decreased visual acuity. Mean logMAR change in visual acuity was -0.09 (range, -1.3 to 0.8). Seventeen of 21 tumors (81%) were flat at last follow-up. The mean decrease in ultrasound-measured thickness was 0.83 mm (range, 2.6 mm decrease to 1.4 mm increase), while the decrease in EDI-OCT-measured thickness was 400 μm (range, 1280 μm decrease to 280 μm increase). Eighteen tumors (86%) had complete resolution of subretinal fluid. There were no PDT-related complications. Photodynamic therapy may be an effective therapeutic option for the management of choroidal metastasis in selected cases.