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Therapeutic effect of modified double-dose photodynamic therapy in circumscribed choroidal haemangioma
Hyeong Ju Byeon1, Ji Hwan Lee1, Junwon Lee1
1Department of Ophthalmology, The Institute of Vision Research, Yonsei University College of Medicine, Seoul, South Korea.
Insights
Modified double-dose photodynamic therapy (PDT) offers superior outcomes for circumscribed choroidal haemangioma (CCH) compared to standard PDT. This approach resulted in greater tumour regression and improved subretinal fluid resolution.
Area of Science:
- Ophthalmology
- Medical Imaging
- Laser Therapy
Background:
- Circumscribed choroidal haemangioma (CCH) is a rare choroidal tumor.
- Photodynamic therapy (PDT) is a treatment option for CCH.
- Optimizing PDT protocols may improve treatment efficacy.
Purpose of the Study:
- To compare the therapeutic effectiveness of modified double-dose PDT versus standard-dose PDT for CCH.
- To evaluate tumour regression and fluid resolution in CCH patients treated with different PDT protocols.
Main Methods:
- Retrospective comparison of 39 patients with CCH divided into standard-dose and modified double-dose PDT groups.
- Standard-dose PDT involved 6 mg/m² verteporfin and 83s laser exposure.
- Modified double-dose PDT used adjusted verteporfin dosage and irradiance time based on body surface area.
Main Results:
- No significant baseline differences between groups.
- Modified double-dose PDT achieved greater reduction in tumour thickness (45.3% vs 20.6%) and volume (60.0% vs 30.0%) at 1 year (p<0.05).
- Standard-dose PDT group showed increased subretinal fluid in recurred or incompletely resolved cases.
Conclusions:
- Modified double-dose PDT is an effective and safe protocol for symptomatic CCH.
- This protocol demonstrates superior tumour regression compared to standard PDT.
- Modified double-dose PDT may offer better resolution of subretinal fluid in CCH management.
Aims:
To retrospectively compare the therapeutic effect of modified double-dose photodynamic therapy (PDT) with standard-dose PDT in patients with circumscribed choroidal haemangioma (CCH).
Methods:
Thirty-nine patients with CCH were categorised in two groups by PDT type. The standard-dose group (n=12) was treated with 6 mg/m2 verteporfin and a 689 nm laser for 83 s. The modified double-dose group (n=27) received one vial of verteporfin (15 mg), and the dose was calculated for each patient based on body surface area, then irradiance time was adjusted according to calculated verteporfin dose to achieve a 'double'-dose effect. Treatment outcomes (foveal centre thickness, subretinal fluid, tumour thickness and diameter) were measured at baseline and 1 year post-treatment; subretinal fluid levels were also measured at 1, 3 and 6 months post-treatment.
Results:
No differences in baseline characteristics were found between the two groups. The modified double-dose group showed a greater reduction in tumour thickness (45.3% vs 20.6%, p=0.013) and tumour volume (60.0% vs 30.0%, p=0.006) at 1 year post-treatment. Recurred or non-complete resolution patients in the standard-dose group tended to show much increased subretinal fluid than those in the modified double-dose group at 1-year post-treatment.
Conclusion:
Modified double-dose PDT is an effective and safe protocol for symptomatic CCH management, greater tumour regression and potentially better resolution of subretinal fluid compared with standard PDT.
