Photodynamic therapy for recurrent hyphema after proton beam radiotherapy of iris melanoma

Abstract

Recurrent hemorrhage with secondary glaucoma is a rare but serious complication following proton beam irradiation (PBI) of iris melanoma. We report a case in which photodynamic therapy (PDT) was successfully used to treat this complication. The history, clinical features and management of a patient with iris melanoma who was treated with PBI and later developed recurrent hyphema and increased intraocular pressure are presented. PDT was used to treat the abnormal intralesional blood vessels which caused the recurrent intraocular haemorrhage. The intralesional blood vessels regressed following PDT. The patient did not experience any further episodes of hyphema or elevated intraocular pressure. Our case demonstrates that the vascular abnormalities following irradiation of iris melanoma may respond favorably to PDT in selected cases. To our knowledge, this is the first reported case in which PDT was used to treat recurrent hyphema caused by abnormal intralesional blood vessels after proton beam irradiation of iris melanoma.