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Objective
To observe the efficacy of photodynamic therapy (PDT) based on indocyanine green angiography (ICGA) for circumscribed choroidal hemangioma (CCH).
Methods
A retrospective observational case series study was performed.Seventeen eyes of 17 patients were diagnosed with CCH and then underwent PDT based on ICGA image in Xuzhou Municipal Hospital from August, 2010 to May, 2018.The size of the treatment spot was decided according to ICGA images.The period of mean follow-up visit ranged from 6 to 36 months, with an average of (23.3±11.8) months.Best corrected visual acuity (BCVA), sub-retinal fluid (SRF) and central retinal thickness (CRT) based on optical coherence tomography (OCT), the tumor diameter based on ICGA and the tumor thickness based on coloured doppler imaging (CDI) before and after treatment were analyzed.
Results
Sixteen cases received only one PDT session, one case had ever received PDT and another case had ever received focal laser photocoagulation.The mean BCVA (LogMAR) was 0.99±0.52, 1.09±0.50, 0.97±0.53, 0.81±0.66, 0.79±0.69, and the mean CRT was (440.76±281.34), (329.18±175.02), (274.24±169.55), (271.53±150.00), (291.06± 201.41)μm before PDT, at 1 week, 1 month, 3 months and the last visit after treatment, with significant differences among the follow-up time (F=6.965, P=0.006; F=8.784, P=0.002). The decimal visual acuity was increased by at least 2 lines in 9 eyes (52.9%), fluctuated within 2 lines in 7 eyes (41.2%), while decreased by at least 2 lines in one eye (5.9%). SRF of all patients was involved in macular area.The absolute absorption of SRF was found in 7 eyes (41.2%) and partial absorption in 8 eyes (47.1%) at 3 months follow-up visit.In the last follow-up visit, the absolute absorption of SRF was found in 12 eyes (70.6%), partial absorption was found in 3 eyes (17.6%) and 2 eyes (11.8%) underwent no change.On FFA and ICGA, the decrease of tumor size was found in 15 patients, while the others underwent no change.All patients underwent less enhanced hyperfluorescent after treatment.The mean tumor height was (3.80±1.13)mm before PDT and (3.42±1.14)mm on the last visit, with a significant difference between them (t=4.101, P=0.010).
Conclusions
PDT with verteporfin for CCH can promote the improvement of visual acuity, the absorption of SRF, the anatomical reposition of the retina and the decrease of tumor size.The majority of patients can get therapeutic effect after one PDT session.