Circumscribed choroidal hemangioma in a Chinese patient treated using transpupillary thermotherapy: a case report

We describe the first case of a Chinese patient with circumscribed choroidal hemangioma (CCH) effectively managed using transpupillary thermotherapy (TTT). A 57-year-old man had an elevated orange-red subretinal mass with a base of 5 x 5 mm superior to the optic disc, along with serous macular detachment in the left eye. Ultrasonography depicted a mass 3 mm thick with acoustic solidity and high internal reflectivity. Fluorescein angiography showed an area of hyperfluorescence in the prearterial phase and tumor staining in the late phase, consistent with a diagnosis of CCH. Therefore, TTT (spot size, 3 mm; exposure, 1 min) was performed with a diode laser, delivered through a slit-lamp biomicroscope. The laser power was first set at 300 mW and then increased in 50-mW increments, until test shots in the mid-peripheral retina outside the lesion produced a slightly grayish appearance in the irradiated area. The tumor was covered with four overlapping laser spots and subjected to an average beam power of 400 mW. Best-corrected visual acuity increased from 20/50 before treatment, to 20/20 3 months following one session of TTT. The lesion became atrophic and the subretinal fluid disappeared. Our experience shows that TTT can be an even more effective treatment strategy for CCH in Asians than in Caucasians. In Chinese patients, the power level of the diode laser should be lower than that used in Caucasians.