ABSTRACT.Purpose: To assess the efficacy of photodynamic therapy (PDT) as a new treatment for circumscribed choroidal haemangioma (CCH). Methods: Eight patients with CCH were treated with PDT using a protocol similar to that used in the standard treatment of neovascular age-related macular degeneration. Results: Visual acuity improved in six of eight eyes, remained unchanged in one eye and deteriorated in one eye after 3-15 months (median 7 months) followup. Pre-treatment metamorphopsia disappeared in all but two cases. The thickness of the CCH measured with standardized echography showed marked regression within 1 month after PDT. In six eyes there was no remaining protrusion after PDT and one lesion was barely detectable. One patient experienced a transient choroidal effusion and perifoveal haemorrhage. Conclusion: Photodynamic therapy is a promising new treatment for CCH as it restores visual function in most cases without causing apparent ocular or systemic side-effects.
ABSTRACT.Purpose: To review the Swedish experience using transpupillary thermotherapy (TTT) as an adjunct to ruthenium plaque radiotherapy for choroidal melanoma. Methods: A retrospective chart review of 27 patients receiving TTT for juxtapapillary or juxtafoveal growth present at the time of diagnosis, or recurrent growth at the tumour margin, or significant exudation following ruthenium brachytherapy for choroidal melanoma. Results: Follow-up ranged from 6 to 29 months (medianΩ20 months). Tumour growth regressed completely (nΩ8), regressed partially (nΩ11), remain unchanged (nΩ6) or progressed (nΩ2). Complications included focal lens opacity with or without associated posterior synechiae (nΩ3), retinal haemorrhage (nΩ 2) and retinal vein occlusion (nΩ1). Seventeen patients (63%) maintained or improved visual acuity and 2 eyes were enucleated following combined treatment. Conclusion: Many of the treated eyes would have been enucleated in the past, suggesting that TTT used in combination with ruthenium brachytherapy improves the short term globe salvage rate. Ocular side effects do occur but are usually not significant.
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