Photodynamic Therapy for Symptomatic Circumscribed Macular Choroidal Hemangioma in Chinese Patients

Abstract

To evaluate the efficacy and safety of photodynamic therapy (PDT) for macular circumscribed choroidal hemangioma in Chinese patients. Retrospective, consecutive, noncomparative case series. Twenty-five eyes (25 patients) with macular circumscribed choroidal hemangioma, 18 subfoveal and 7 perifoveal, with vision impairment attributable to subfoveal fluid and retinal detachment underwent visual acuity testing, fundus fluorescein angiography, ultrasonography, and optical coherence tomography (OCT) examinations to evaluate the efficacy and safety of PDT treatment. PDT was performed with a standard concentration of verteporfin and intravenous injection time. Laser was used at 50 J/cm² for 83 seconds on subfoveal and 75 J/cm² for 125 seconds on perifoveal lesions. More than 1 spot was used for large lesions and spots overlapped only outside the fovea. The mean follow-up time was 35.5 ± 15 months. All patients were treated with 1 session except in 2 subfoveal cases. The mean best-corrected visual acuity (BCVA) increased from 0.09 ± 0.11 to 0.31 ± 0.37 (P < .01) and 11 patients (44%) had their vision improve over 4 lines. The remaining 14 patients (56%) had stabilized vision with the retina reattached. The mean thickness of the hemangioma before the treatment was 3.2 ± 0.9 mm and decreased to 1.3 ± 1.0 mm post treatment (P < .01), with complete regression of tumor in 7 cases (28%). PDT with individualized laser parameters for macular circumscribed choroidal hemangioma is effective and safe, leading to improved or stabilized BCVA as a result of tumor shrinkage and the resolution of the subretinal fluid.