Long-term Follow-up after Photodynamic Therapy of Choroidal Hemangioma
Michels R., Michels S., Schmidt-Erfurth U.
Universitätsklinikum Schleswig-Holstein, Campus Lübeck
Purpose: Choroidal hemangioma typically respond to photodynamic therapy (PDT) using verteporfin with a fast regression and visual improvement, however, the long-term prognosis is unknown. A long-term follow-up over three years was performed for the first time.
Method: 15 consecutive patients with symptomatic choroidal hemangioma located at the posterior pole were included into a prospective, interventional study. Treatment with verteporfin-PDT was performed using a bolus application with a drug dose of 6 mg/mm2 body surface area and a light dose of 100 J/cm2. In case of persistent tumor residuals documented by ultrasound, retreatment was indicated after 6 weeks. Standardized examinations using fundusphotographie, ETDRS-visual test, fluorescein and indocyanine green angiography were scheduled every 3 months during the first year and yearly for up to three years of follow-up.
Results: The initial visual acuity was 20/125 on average, the mean tumor height was 3.8 mm. A complete regression was achieved in all eyes after one to four treatment courses. The mean visual acuity immediately after treatment discontinuation was 20/80. At a follow-up of 36 months, the anatomical and functional status was unchanged in all patients. Mean visual acuity remained 20/80. The visual improvement obtained earlier in 13 of 15 patients was maintained. The central area of chorioretinal atrophy did no
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