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Retinal fluid changes and therapeutic effects in symptomatic circumscribed choroidal hemangioma patients: a long-term

Junwon Lee1, Christopher Seungkyu Lee2, Min Kim2

  • 1Department of Ophthalmology, Eye and ENT Hospital, Severance Hospital, Institute of Vision Research, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, South Korea.

BMC Ophthalmology
|December 15, 2018
PubMed

Insights

Retinal fluid patterns in circumscribed choroidal hemangioma evolve to advanced cystoid macular edema. Photodynamic therapy (PDT) is most effective, especially for advanced cases, while other treatments show diminishing efficacy over time.

Area of Science:

  • Ophthalmology
  • Retinal Diseases
  • Choroidal Neovascularization

Background:

  • Circumscribed choroidal hemangioma (CCH) can cause retinal fluid accumulation.
  • Retinal fluid pattern changes and treatment efficacy in CCH have not been well-documented.

Purpose of the Study:

  • To investigate the evolution of retinal fluid patterns in CCH patients.
  • To evaluate the long-term treatment responses for different fluid patterns in CCH.

Main Methods:

  • Retrospective review of 26 treatment-naïve CCH patients with over 2 years of follow-up.
  • Analysis of best corrected visual acuity (BCVA) and optical coherence tomography (OCT) findings, including subretinal fluid (SRF) and intraretinal fluid (IRF) patterns.
  • Evaluation of treatment outcomes for photodynamic therapy (PDT), thermal therapy (TTT), and intravitreal bevacizumab (IVB).

Main Results:

  • Initially, SRF-only patterns were common. Over time, intraretinal fluid (IRF) developed, leading to advanced cystoid macular edema (CME).
  • PDT showed 100% efficacy in initial treatment. TTT and IVB had moderate efficacy (57.1% and 50%, respectively).
  • For advanced CME, PDT remained effective (60%), while TTT and IVB showed minimal to no effect (0%).

Conclusions:

  • Retinal fluid patterns in CCH progress from SRF to advanced CME.
  • Treatment efficacy decreases as the condition progresses, with advanced CME being resistant to TTT and IVB.
  • Photodynamic therapy (PDT) is the most recommended treatment for CCH, particularly for managing advanced cystoid macular edema.
Abstract

Keywords:
Choroidal hemangiomaCystoid macular oedemaPhotodynamic therapyRetinal fluid pattern

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