Diffuse choroidal haemangioma in Sturge–Weber syndrome treated with photodynamic therapy under general anaesthesia

Abstract

In our patient PDT with verteporfin effectively resolved the exudative retinal detachment associated with a diffuse choroidal haemangioma. Resolution of subretinal fluid occurred over several months without retreatment. We noted no side effects of the combination PDT and general anaesthesia, nor did we encounter ocular side effects of the treatment.

Sympathetic Ophthalmia in a 22-Month-Old Infant With Sturge–Weber Syndrome With Atypical Histopathological Correlation

“…Alterations in choroidal vessels are the cause of complications, like the exudative retinal detachment seen in our patient. [7][8][9][10][11][12] In the context of diffuse choroidal hemangiomas and low intraocular pressure, an exuberant inflammatory response may have been elicited, making both the choroidal effusions and exudative retinal detachment very difficult to manage in our patient. A previous report of a pediatric case by Kaushik et al 9 mentioned that choroidal effusions and retinal detachment refractory to most conventional treatment modalities in the setting of SWS may require multiple treatments (antivascular endothelial growth factor, oral propranolol, surgical drainage, etc) 13 to stop the cycle of effusion, hypotony, and inflammation that, after established, is difficult to stabilize.…”

“…Alterations in choroidal vessels are the cause of complications, like the exudative retinal detachment seen in our patient. 7 –12…”

Sympathetic Ophthalmia in a 22-Month-Old Infant With Sturge–Weber Syndrome With Atypical Histopathological Correlation

“…Alterations in choroidal vessels are the cause of complications, like the exudative retinal detachment seen in our patient. [7][8][9][10][11][12] In the context of diffuse choroidal hemangiomas and low intraocular pressure, an exuberant inflammatory response may have been elicited, making both the choroidal effusions and exudative retinal detachment very difficult to manage in our patient. A previous report of a pediatric case by Kaushik et al 9 mentioned that choroidal effusions and retinal detachment refractory to most conventional treatment modalities in the setting of SWS may require multiple treatments (antivascular endothelial growth factor, oral propranolol, surgical drainage, etc) 13 to stop the cycle of effusion, hypotony, and inflammation that, after established, is difficult to stabilize.…”

“…Alterations in choroidal vessels are the cause of complications, like the exudative retinal detachment seen in our patient. 7 –12…”

An Update on Multimodal Ophthalmological Imaging of Diffuse Choroidal Hemangioma in Sturge–Weber Syndrome

“…These strategies are particularly useful when DCHs are enlarging and present a persistent subretinal fluid, whereas extensive retinal detachment may require scleral buckling surgery with vitrectomy and gas injection. Oral propranolol efficacy varies in the literature [ 45 , 84 , 85 , 86 , 87 , 88 ].…”

Sturge-Weber syndrome: decrease in intraocular pressure after transpupillary thermotherapy for diffuse choroidal haemangioma

“…In spite of its efficacy, TTT remains debated because it cannot be used in the face of exudative RD, which is the main indication to treat DCH. In the latter situation, photodynamic therapy is a safe and efficient alternative to radiotherapy but it did not have a demonstrable effect on IOP (Anand 2003; Huiskamp et al. 2005).…”

Sympathetic Ophthalmia in a 22-Month-Old Infant With Sturge–Weber Syndrome With Atypical Histopathological Correlation

“…Alterations in choroidal vessels are the cause of complications, like the exudative retinal detachment seen in our patient. [7][8][9][10][11][12] In the context of diffuse choroidal hemangiomas and low intraocular pressure, an exuberant inflammatory response may have been elicited, making both the choroidal effusions and exudative retinal detachment very difficult to manage in our patient. A previous report of a pediatric case by Kaushik et al 9 mentioned that choroidal effusions and retinal detachment refractory to most conventional treatment modalities in the setting of SWS may require multiple treatments (antivascular endothelial growth factor, oral propranolol, surgical drainage, etc) 13 to stop the cycle of effusion, hypotony, and inflammation that, after established, is difficult to stabilize.…”

“…Alterations in choroidal vessels are the cause of complications, like the exudative retinal detachment seen in our patient. 7 –12…”

An Update on Multimodal Ophthalmological Imaging of Diffuse Choroidal Hemangioma in Sturge–Weber Syndrome

“…These strategies are particularly useful when DCHs are enlarging and present a persistent subretinal fluid, whereas extensive retinal detachment may require scleral buckling surgery with vitrectomy and gas injection. Oral propranolol efficacy varies in the literature [ 45 , 84 , 85 , 86 , 87 , 88 ].…”

Sturge-Weber syndrome: decrease in intraocular pressure after transpupillary thermotherapy for diffuse choroidal haemangioma

“…In spite of its efficacy, TTT remains debated because it cannot be used in the face of exudative RD, which is the main indication to treat DCH. In the latter situation, photodynamic therapy is a safe and efficient alternative to radiotherapy but it did not have a demonstrable effect on IOP (Anand 2003; Huiskamp et al. 2005).…”

Sympathetic Ophthalmia in a 22-Month-Old Infant With Sturge–Weber Syndrome With Atypical Histopathological Correlation

“…Alterations in choroidal vessels are the cause of complications, like the exudative retinal detachment seen in our patient. [7][8][9][10][11][12] In the context of diffuse choroidal hemangiomas and low intraocular pressure, an exuberant inflammatory response may have been elicited, making both the choroidal effusions and exudative retinal detachment very difficult to manage in our patient. A previous report of a pediatric case by Kaushik et al 9 mentioned that choroidal effusions and retinal detachment refractory to most conventional treatment modalities in the setting of SWS may require multiple treatments (antivascular endothelial growth factor, oral propranolol, surgical drainage, etc) 13 to stop the cycle of effusion, hypotony, and inflammation that, after established, is difficult to stabilize.…”

“…Alterations in choroidal vessels are the cause of complications, like the exudative retinal detachment seen in our patient. 7 –12…”

An Update on Multimodal Ophthalmological Imaging of Diffuse Choroidal Hemangioma in Sturge–Weber Syndrome

“…These strategies are particularly useful when DCHs are enlarging and present a persistent subretinal fluid, whereas extensive retinal detachment may require scleral buckling surgery with vitrectomy and gas injection. Oral propranolol efficacy varies in the literature [ 45 , 84 , 85 , 86 , 87 , 88 ].…”

Sturge-Weber syndrome: decrease in intraocular pressure after transpupillary thermotherapy for diffuse choroidal haemangioma

“…In spite of its efficacy, TTT remains debated because it cannot be used in the face of exudative RD, which is the main indication to treat DCH. In the latter situation, photodynamic therapy is a safe and efficient alternative to radiotherapy but it did not have a demonstrable effect on IOP (Anand 2003; Huiskamp et al. 2005).…”