Photodynamic therapy for choroidal hemangioma associated with serous retinal detachment

To describe the clinical findings in 3 eyes with circumscribed choroidal hemangioma before and after treatment with photodynamic therapy.

In the setting of a tertiary referral center, 2 patients with circumscribed, posteriorly located, choroidal hemangiomas (thicknesses 2.4 and 2.9 mm) contiguous with the superior boundary of the optic nerve and accompanied by serous detachments of the sensory retina extending into the macula were treated with photodynamic therapy using a Zeiss diode laser (692 nm) and a sensitizing dye, verteporfin. A third patient with a circumscribed subfoveal hemangioma (3.9 mm in thickness) and a prominent serous retinal detachment was similarly treated. The tumors were studied with ultrasonography and fluorescein angiography. Visual fields were tested with Goldmann perimetry at follow-up.

Following photodynamic therapy, the serous retinal detachments resolved, and the choroidal hemangioma in each of the 3 eyes regressed to a nonmeasurable thickness within 2 to 5 months. The visual acuity improved from 20/50 to 20/20, 20/150 to 20/20, and 3/200 to 20/200 in the respective cases. Two eyes were treated twice. The tumors have not recurred at follow-up visits from 11 to 16 months. Nerve fiber bundle field defects were not demonstrated with Goldmann field testing.

Photodynamic therapy seems to be effective in the management of circumscribed choroidal hemangioma. Following photodynamic therapy, the choroidal hemangiomas in 3 eyes were no longer measurable by ultrasonography, and the accompanying serous detachments resolved with improvement in the central visual acuities. Nerve fiber bundle defects were not identified.