Transpupillary thermotherapy in the treatment of circumscribed choroidal hemangiomas.

Abstract

To evaluate the efficacy of transpupillary thermotherapy (TTT) for the treatment of serous retinal detachment secondary to circumscribed choroidal hemangiomas (CCH). Four eyes of four consecutive patients who presented decreased vision due to serous macular detachment secondary to CCH were enrolled in this study. After informed consent was obtained, the four eyes were treated with TTT. All the patients underwent pretreatment ocular examination, which included fluorescein angiography and ultrasonography. TTT was applied using a diode laser at 810 nm with a spot size of 4.3 mm. The diode laser was transmitted through a contact lens. The end-point of the treatment was a detectable light-gray appearance of the entire lesion. The patients were re-examined monthly during the first 6 months, and regularly thereafter. Within 3 months of treatment all eyes had already demonstrated decreased exudation on clinical examination and on fluorescein angiography. Reduction in tumor prominence was observed in all eyes by A-B ultrasonography. Three patients showed an improvement in visual acuity (VA) over a period of 6 months. Case 2 from 20/60 to 20/25; case 3 from 20/400 to 20/50 and case 4 from 20/80 to 20/20. The VA in case 1 remained unchanged (counting fingers). No recurrences were observed within a mean follow-up of 14.5 months. TTT showed no deleterious side effects in treating serous macular detachment secondary to CCH, and must be regarded as a therapeutic alternative to manage selected cases.