| Abstract | BACKGROUND: Photodynamic therapy has recently advanced to a first line treatment of symptomatic circumscribed choroidal hemangiomas. HISTORY AND SIGNS: A sixty-year-old male patient was referred with progressive visual loss in his left eye. Visual acuity measured 20/80 and fundus examination revealed a prominent red subretinal lesion superior to the fovea with adjacent pigment epithelial irregularities. Thickening of the central retina was seen on OCT imaging. Sonography revealed a dome-shaped lesion with a maximal thickness of 3.3 mm and high internal reflectivity. Combined fundus indocyanine green and fluorescein angiography showed early filling of large vessels within the tumor. THERAPY AND OUTCOME: The hemangioma was treated with verteporphin photodynamic therapy. Two days after treatment, with vision unchanged, fundus examination revealed blackening of the tumor. Two months later vision increased to 20/40 and the tumor area was atrophic and bright red with a slight hyperpigmented rim. Angiography revealed the disappearance of tumor vessels and choroidal hypoperfusion in the area of treatment. CONCLUSIONS: Choroidal hemangiomas may darken initially after photodynamic therapy. This is most probably caused by large coaguli within the voluminous lacuna-like blood-filled vessel system of the hemangioma that are induced by photothrombosis. |
| Authors | M M Bosch, H Helbig
(Affiliation: Department of Ophthalmology, University Hospital Zurich, Zurich, Switzerland. martina.boesch at usz.ch)
|
| Journal | Klinische Monatsblätter für Augenheilkunde
(Klin Monatsbl Augenheilkd)
Vol. 222
Issue 3
Pg. 258-60
(Mar 2005)
ISSN: 0023-2165 Germany |
| PMID | 15785995
(Publication Type: Case Reports, Journal Article)
|
| Topics |
- Atrophy
- Choroid
(pathology)
- Choroid Neoplasms
(diagnosis, drug therapy, pathology)
- Fluorescein Angiography
- Fundus Oculi
- Hemangioma
(diagnosis, drug therapy, pathology)
- Hematoporphyrin Photoradiation
- Humans
- Male
- Middle Aged
- Ophthalmoscopy
- Pigmentation Disorders
(etiology)
|
