Photodynamic Therapy with Verteporfin for Symptomatic Circumscribed Choroidal Hemangioma: Five-Year Outcomes

Photodynamic therapy: current role in the treatment of chorioretinal conditions

“…Multiple case series have been reported demonstrating that vPDT therapy achieves high rates of tumour control with minimal complications. [33][34][35][36][37][38] Choroidal haemangiomas can be effectively treated using the standard vPDT protocol-verteporfin dosage 6 mg/m 2 BSA and vPDT laser fluence 50 J/cm 2 (600 mW/cm 2 for 83 s). 36,37 Alternative vPDT protocols have been reported, generally involving a higher vPDT laser fluence of 100 J/cm 2 (600 mW/cm 2 for 166 s).…”

“…36,37 Alternative vPDT protocols have been reported, generally involving a higher vPDT laser fluence of 100 J/cm 2 (600 mW/cm 2 for 166 s). [33][34][35]38 The maximum laser spot size generated by most vPDT laser systems is around 7000 μm. Consequently, treatment of larger choroidal haemangiomas may require multiple, partially overlapping laser spots (administered during the same treatment session).…”

Imaging of retinal and choroidal vascular tumours

“…26 Fluorescein and ICG angiography have traditionally been used to monitor the vascular activity of choroidal haemangiomas following treatment. This has now been superseded by monitoring the secondary effects with SD-OCT. 8 The value of SD-OCT in the assessment of choroidal haemangioma lies in the detection and quantification of associated retinal changes ( Figure 3). These include suband intraretinal fluid, retinal schisis, photoreceptor loss, and retinal atrophy.…”

“…They more closely resemble a diffuse choroidal angiomatosis than a localized vascular tumour. 8 On ultrasonography, the extension of the lesion usually exceeds the apparent diameter based on indirect ophthalmoscopy. Wide-angle ICG angiography is useful in determining the extent of the haemangioma.…”

“…1,2 In addition to conventional radiotherapy, cryotherapy, and laser photocoagulation, new therapeutical options include anti-VEGF pharmacotherapy, proton beam radiotherapy, photodynamic therapy, and small gauge vitrectomy. [3][4][5][6][7][8] These have been reviewed elsewhere and are therefore not discussed in the present article.…”