Three Cases of Large Retinal Capillary Hemangiomas Treated With Verteporfin and Photodynamic Therapy

Abstract

Objective: To investigate the efficacy of verteporfin and photodynamic therapy in the treatment of large retinal capillary hemangiomas.Methods: Case reports of 3 patients with large retinal capillary hemangiomas treated with photodynamic therapy using verteporfin. Standard verteporfin dosages (6 mg/m 2 of body surface area) were given. Both standard and modified photodynamic protocols were followed. Modified protocols included shorter verteporfin infusion times and longer light exposure times.Results: Pretreatment best-corrected Snellen visual acuity of the 3 affected eyes were 20/100, 20/50, and 2/200, respectively. All cases had associated exudative retinal detachments involving the macula. Cases 1 and 2 were classic endophytic retinal capillary hemangiomas. Case 3 was a reactive retinal capillary hemangioma. Case 1 had 2 photodynamic therapy treatments, and after 8 months, visual acuity improved to 20/40. Two years after initiating photodynamic therapy, the visual acuity was 20/30 and there was no reperfusion of the hemangioma. Case 2 had 3 photodynamic therapy treatments. The hemangioma was fibrotic, and 20 months after initiating photodynamic therapy visual acuity improved to 20/30. Case 3 had 1 treatment, 11 weeks later and visual acuity improved to 20/400. Four months after treatment, visual acuity returned to counting fingers because of tractional elevation of the macula as the capillary hemangioma fibrosed. Vitrectomy surgery was performed, and choroidal and retinal neovascularization was discovered. Three months after vitrectomy visual acuity was 20/ 400. In cases 1 and 2, the capillary hemangioma ultimately regressed, and the exudative detachment resolved.Conclusions: Verteporfin and photodynamic therapy were effective in achieving closure of large retinal capillary hemangiomas. In all cases, the hemangioma underwent fibrosis with consequent macular puckering due to retinal traction. In all cases, the visual acuity improved.

Ocular Photodynamic Therapy – Standard Applications and New Indications (Part 2)

“…Laser light was delivered at 100 J/cm 2 for an interval of 8–168 s. One to three PDT sessions were performed. Additional case reports or small case series by Obana et al [23], Aaberg et al [24], Szabo et al [25] and Golshevsky et al [26] presented PDT to be a promising therapeutic option, nevertheless they suggested further investigation on optimal radiance avoiding damage to the retinal vasculature and optic nerve.…”

Temporary exudative retinal detachment following photodynamic therapy in a patient with retinal capillary hemangioblastoma

“…PDT is still a valid treatment option for retinal hemangiomas 3–7. While some authors prefer the standard protocol used in wet age-related macular degeneration,5–8 others use modified PDT protocols such as halving the infusion time to 5 minutes3 and/or prolonging the exposure34 to 166 seconds.…”

“…While some authors prefer the standard protocol used in wet age-related macular degeneration,5–8 others use modified PDT protocols such as halving the infusion time to 5 minutes3 and/or prolonging the exposure34 to 166 seconds. PDT is either applied over the tumor and/or the feeding and draining vessels 3…”

Photodynamic Therapy and Vitrectomy for a Large Optic Nerve Hemangioma With Neovascularization and Retinal Detachment: A Clinicopathologic Correlation

“…[3][4][5][6] In this case, we believe that PDT induced regression of the hemangioma and concomitantly stopped its exudative response. The favorable central visual acuity suggests a durability of the response, despite the initial increase in exudation and subretinal hemorrhage, which was a transient phenomenon.…”