Photodynamic Therapy for Diffuse Choroidal Hemangioma in Sturge-Weber Syndrome

Abstract

Purpose. To report the treatment outcome of photodynamic therapy with verteporfin (PDT) for exudative retinal detachment (RD) associated with diffuse choroidal hemangioma in Sturge-Weber syndrome (SWS). Methods. An interventional case report of a 10-year-old girl with SWS who developed an exudative RD (visual acuity hand motions) that was treated with PDT. She was treated with a first session of multispot PDT. Posteriorly, a choroidotomy for drainage of subretinal fluid was created, combined with an intravitreal injection of gas (SF6) and cryoapplication. Finally, a second session of PDT was applied. Results. Subretinal fluid resolved over a period of one year and visual acuity increased to 20/125. Conclusions. PDT is an effective therapeutic option for exudative RD associated with diffuse choroidal hemangioma.

Low‐dose proton radiotherapy for pediatric choroidal hemangioma: A case series

“…In the nine patients who received this fractionation scheme, outcomes were generally excellent and similar to those observed after EBRT for CCH in adult patients 2,4–9 . Although use of anti‐VEGF agents, propranolol, photodynamic therapy, and plaque brachytherapy have been described for exudative DCH, published data supporting their use remain limited 3,10–14 . Moreover, failure of propranolol and anti‐VEGF therapies in several patients in our study raises questions regarding their utility.…”

“…2,[4][5][6][7][8][9] Although use of anti-VEGF agents, propranolol, photodynamic therapy, and plaque brachytherapy have been described for exudative DCH, published data supporting their use remain limited. 3,[10][11][12][13][14] Moreover, failure of propranolol and anti-VEGF therapies in several patients in our study raises questions regarding their utility.…”

Clinical use of photodynamic therapy in ocular tumors

“…20,50,151,166,193 In 13 cases, PDT was applied for 166 seconds in the first session. 1, 140,166,113,126,226 Seven of these cases exhibited improved or stable vision, 2, 166,186, 226 four had macular fibrosis, 2, 140 two had a transient increase in exudation, 166,171 and one had vitreous hemorrhage. 186 In two cases, half-fluence was used, and in one patient, a one-and-a-half duration of the standard dose was applied.…”

“…The most frequent treatment modality for diffuse choroidal hemangioma is external beam radiotherapy, with photons in 31 cases 73,74,81,113,138,148,162 and with protons in 21 cases. 47,81,221 The third most common method reported in the literature is PDT, which was used in 10 cases, where 7 cases were followed up after at least 6 months, 11,39,88,126,179,203 and 3 cases in 3 studies were followed up in less than 6 months. 9,18,203 In all cases treated with PDT, standard protocol with verteporfin was used, and the results are promising.Visual acuity increased, exudation resolved, and tumor size regressed.…”

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 ].…”