Verteporfin photodynamic therapy of retinal optic disc haemangioma

Abstract

AbstractPurpose Retinal optic disc haemangioma are difficult to manage. Observation as well as therapeutical interventions may result in irreversible visual loss. We investigated verteporfin photodynamic therapy (PDT) as the initial treatment method for these tumours.Methods Retrospective review of patients with optic disc haemangioma not associated with v. Hippel‐Lindau disease and a minimum follow‐up of 1 year.Results Between January 2009 and June 2010, we treated three patients with PDT and standard parameters as the initial intervention. All patients presented with symptomatic visual loss caused by macular oedema. In a 67‐year‐old female patient, complete regression could be achieved with a single PDT after 14m follow‐up. Best corrected visual acuity (BCVA) improved from 6/60 to 6/18. In a 55‐year‐old male patient, no regression of the angioma could be induced despite 5 consecutive PDT sessions. After a 24m follow‐up, BCVA decreased from 6/9 to counting fingers. In a 24‐year‐old female patient, a single PDT induced complete regression and BCVA improved from 6/12 to 6/9 over 12m. The treatment was initially complicated by a shutdown of the choroidal perfusion with temporary visual loss immediately following the PDT.Conclusion In this small series, treatment response of optic disc haemangioma to PDT varied significantly between cases. A complete regression of two angiomas as well as no visible reaction to PDT in a third case could be observed. Alternative treatment modalities should be employed if the haemangioma does not respond to the initial treatment cycles and is complicated by progression of the disease.