Photodynamic therapy of circumscribed choroidal hemangioma

Porrini, Giulio; Giovannini, A.; Amato, G. P.; Ioni, Alfonso; Pantanetti, Marco

doi:10.1016/s0161-6420(02)01968-1

Cited by 98 publications

(67 citation statements)

References 25 publications

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“…[45] PDT is typically performed with administration of intravenous verteporfin at a dose of 6 mg/m 2 followed by treatment with laser wavelengths of 689, 690, or 692 nm at an intensity of 600 mW/cm 2 with durations ranging from 83 to 166 seconds (50-100 J/cm 2 ). [46][47][48][49][50] PDT has been shown to eliminate subretinal fluid caused by subfoveal neovascularization. Although the non-growing vascular channels in choroidal hemangiomas are different as compared to those of neovascular tissue, PDT might be able to cause atrophy of the hemangioma vessels and thus decrease leakage and the associated vision loss.…”

Section: Photodynamic Therapy (Pdt)mentioning

confidence: 99%

“…[46] There have been numerous case series describing patients with circumscribed choroidal hemangioma in which the majority of subjects received one PDT treatment. [46][47][48][49][50][51][52][53][54] In two case series, the vast majority of patients required more than one PDT treatment because the treatment goal was complete resolution of the tumor, not just resolution of subretinal and intraretinal fluid. [50,51] Considering several case series on PDT for choroidal hemangioma, the baseline tumor thickness ranged from 2.6 to 3.8 mm.…”

Section: Photodynamic Therapy (Pdt)mentioning

confidence: 99%

“…All patients displayed tumor regression to some extent, and 7-100% had complete tumor resolution. [46][47][48][49][50][51][52][53][54] More sessions of PDT may increase the risk of choroidal atrophy and neurosensory retinal degeneration. [51] Visual acuity improvement has been shown to be inversely associated with the number of PDT sessions.…”

Section: Photodynamic Therapy (Pdt)mentioning

confidence: 99%

“…Whether this is a side effect of PDT per se or because larger tumors need more PDT sessions is unknown. [50][51][52] In a study including 50 patients, 95% of the subjects required only one session of PDT with complete resolution of the tumor and fluid. A second session was needed in 5% to resolve persistent or recurrent subretinal fluid.…”

Section: Photodynamic Therapy (Pdt)mentioning

confidence: 99%

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Circumscribed choroidal hemangioma

Mashayekhi

Shields

2003

Current Opinion in Ophthalmology

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Circumscribed choroidal hemangiomas are benign vascular hamartomas without systemic associations. Generally, they are orange-red elevated masses, which are found posterior to the equator. Lesions are usually solitary and unilateral. Overlying subretinal fluid, serous retinal detachment and cystoid macular edema are common findings. Intravenous fluorescein angiography, indocyanine green angiography, ultrasonography, optical coherence tomography and enhanced depth imaging are helpful ancillary tests for diagnosis of circumscribed choroidal hemangiomas. Asymptomatic circumscribed choroidal hemangiomas do not require treatment. For symptomatic lesions with exudative retinal detachment or cystoid macular edema, photodynamic therapy has emerged as the treatment of choice with high rates of tumor regression, subretinal fluid resorption and minimal complications. Lens-sparing external beam radiotherapy, plaque brachytherapy, proton beam therapy, stereotactic radiosurgery, transpupillary thermotherapy, laser photocoagulation and anti-VEGF injections are other treatment modalities.

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Section: Photodynamic Therapy (Pdt)mentioning

confidence: 99%

Section: Photodynamic Therapy (Pdt)mentioning

confidence: 99%

Section: Photodynamic Therapy (Pdt)mentioning

confidence: 99%

Section: Photodynamic Therapy (Pdt)mentioning

confidence: 99%

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Circumscribed choroidal hemangioma

Mashayekhi

Shields

2003

Current Opinion in Ophthalmology

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“…45 The treatment technique has varied between investigators with some following TAP protocol [46][47][48] and others favouring a bolus injection to compensate for altered haemodynamics within the choroidal haemangioma. [49][50][51][52] We have preferred to use the standard TAP study protocol rather than a bolus injection because of greater experience with TAP study protocol and equally good results obtained in patients treated with either protocol.…”

Section: Indications and Resultsmentioning

confidence: 99%

Ocular phototherapy

Singh

2012

Eye

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Phototherapy can be translated to mean 'light or radiant energy-induced treatment.' Lasers have become the exclusive source of light or radiant energy for all applications of phototherapy. Depending on the wavelength, intensity, and duration of exposure, tissues can either absorb the energy (photocoagulation, thermotherapy, and photodynamic therapy (PDT)) or undergo ionization (photodisruption). For phototherapy to be effective, the energy has to be absorbed by tissues or more specifically by naturally occurring pigment (xanthophyll, haemoglobin, and melanin) within them. In tissues or tumours that lack natural pigment, dyes (verteporphin, Visudyne) with narrow absorption spectrum can be injected intravenously that act as focal absorbent of laser energy after they have preferentially localized within the tumour. Ocular phototherapy has broad applications in treatment of ocular tumours. Laser photocoagulation, thermotherapy, and PDT can be delivered with low rates of complications and with ease in the outpatient setting. Review of the current literature suggests excellent results when these treatments are applied for benign tumours, particularly for vascular tumours such as circumscribed choroidal haemangioma. For primary malignant tumours, such as choroidal melanoma, thermotherapy, and PDT do not offer local tumour control rates that are equivalent or higher than those achieved with plaque or proton radiation therapy. However, for secondary malignant tumours (choroidal metastases), thermotherapy and PDT can be applied as a palliative treatment. Greater experience is necessary to fully comprehend risks, comparative benefits, and complication of ocular phototherapy of ocular tumours.

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Low-Dose Proton Beam Therapy for Circumscribed Choroidal Hemangiomas

Frau

Rumen²,

Noël³

et al. 2004

Arch Ophthalmol

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To evaluate the efficacy and safety of proton beam therapy for complicated circumscribed choroidal hemangiomas. Methods: The study was a retrospective nonrandomized investigation. Seventeen consecutive patients, referred to the Institut Gustave-Roussy, Villejuif, France, for circumscribed choroidal hemangioma associated with serous retinal detachment were studied. Each eye received a total dose of 20 cobalt gray equivalents (CGEs) delivered in 15-second fractions of 5 CGEs over 4 days. Functional tests included the initial and final bestcorrected visual acuity, slitlamp examination, intraocular pressure, fundus examination, fluorescein angiography, and indocyanine green angiography. Tumor thickness was determined on B-scan ultrasonography. Results: The macula was involved in 7 eyes and the lesion was juxtapapillary in 2 eyes. The mean (SD) tumor thickness was 3.06 (9.0) mm. The mean initial tumor diameter was 6.82 mm (range, 3.2-12.1 mm). The right eye was involved in 7 cases and the left eye in 10 cases. The mean (SD) follow-up period was 52 (58) months (range, 36-90 months). Retinal reattachment was obtained in all cases after a mean period of 2 months (range, 1-12 months; median, 1 month). Tumor regression was obtained in all cases. One recurrence occurred 1 year after the initial treatment in an undertreated area. After re-treatment, however, resolution of the retinal detachment occurred, and flattening of the choroidal lesion was obtained. Final visual acuity improved to 2 Snellen lines or more in 16 eyes (94%), was stable in 1 eye, and attained 20/40 or more in 12 eyes (70.6%). No radiation therapy complications occurred during follow-up. Conclusions: Proton beam therapy for choroidal hemangiomas seems to be an effective and safe alternative option. A total dose of 20 CGEs delivered in 4 daily 15second fractions of 5 CGEs seems adequate for local control of both the tumor and serous retinal detachment.

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Photodynamic therapy of circumscribed choroidal hemangioma

Cited by 98 publications

References 25 publications

Circumscribed choroidal hemangioma

Circumscribed choroidal hemangioma

Ocular phototherapy

Low-Dose Proton Beam Therapy for Circumscribed Choroidal Hemangiomas

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