Therapeutic effect of photodynamic therapy and transpupillary thermotherapy on circumscribed choroid hemangioma

Abstract

Objective To observe the therapeutic effect of photodynamic therapy (PDT) and transpupillary thermotherapy (TTT) on circumscribed choroid hemangioma (CCH).Methods Clinical data of 32 patients (33 eyes) with CCH diagnosed by ocular fundus examination,fundus fluorescein angiography (FFA),indocyanine green angiography (ICGA),optical coherence tomography (OCT) and B-ultrasound examination were retrospectively analyzed.Before the therapy the selected cases had best corrected visual acuity (BCVA) of finger-counting/15 cm-0.2,the sizes of 2-10 disc diameter (DD) and serous retinal detachment.Twenty-one patients (22 eyes) whose tumor located at the posterior pole except for the papillomacular bundle and arch ring area underwent TTT.The parameters of TTT included:Iris 810 nm infra red diode laser,700-1200 mW,60 s,and 1-3 spots.Eleven patients (11 eyes) with tumor located at the posterior pole except for the papillomacular bundle and arch ring area underwent.After 15 minutes of intravenous injection with Visudyne,laser irradiation with the wavelength of 689 nm was performed with the time of 83-123 s.The follow-up period was 12-48 months with the mean of 25.6 months.BCVA and results of indirect ophthalmoscopy,fundus photogrphy,FFA,ICGA,OCT and B-ultrasound examination were exanmined and anlyzed.Results In the 22 eyes in TTT group,the BCVA improved in 15 and kept unchanged in 7;the results of fundus examinations showed healed retina and atrophy tumor with grey-white organized scar;the results of FFA revealed no fluorescence leakage and scar fluorescence dyeing of the lesion in later period;the results of OCT indicated disappeared retinal detachment,completely absorbed subretinal liquid and increased reflection of ehoroid tumor with sear;the results of D-ultrasound examination showed no retinal detachment and atrophy tumor.In 11 eyes in PDT group,the BCVA improved in 9,unchanged in 2;the results of fundus examinations showed atrophy tumor with pigmentation;the results of FFA revealed disappeared fluorescence leakage;the results of OCT indicated completely absorbed subretinal liquid;the results of B-ultrasound examination showed atrophy tumor.Conclusions Both TTT and PDT can make the tumor atrophy,improve BCVA or keep it still;but apply to different area. Key words: Hemangioma/therapy; Hyperthermia,induced/methods; Photochemotherapy/methods; Treatment outcome