Clinical outcomes and predictors of response to photodynamic therapy in symptomatic circumscribed choroidal hemangioma: A retrospective case series.

Abstract

BACKGROUND:

To investigate the treatment outcomes and predictors of response to photodynamic therapy (PDT) in patients with symptomatic circumscribed hemangioma (CCH).

METHODS:

This retrospective case series examined 20 patients with symptomatic CCH (10 submacular CCHs and10 juxtapapillary CCHs) who underwent standard PDT (wavelength: 662 nm; light dose: 50J/cm2; exposure time: 83 sec) with verteporfin (6mg/m2), either as monotherapy (n = 9) or in association with other treatments (n = 11), of which 7 received intravitreal injections (IVI) of anti-vascular endothelial growth factor (anti-VEGF). A post-PDT improvement of at least two lines in best-corrected visual acuity (BCVA) was the primary outcome measure. Predictors of response were investigated with binary logistic regression analysis.

RESULTS:

Seventeen (85%) patients received one PDT session, and three patients (15%) underwent PDT at least twice. Ten patients (50%) achieved the primary outcome of a post-PDT BCVA improvement of at least two lines. Macular atrophy and recalcitrant cystoid macular edema in 2 patients. Binary logistic regression analysis revealed that younger age (< 50 years) (P = 0.033), pre-PDT BCVA of ≧20/200 (P = 0.013), exudative retinal detachment resolved within one month after PDT (P = 0.007), and a thinner post-PDT tumor thickness (P = 0.015) were associated with the achievement of a post-PDT BCVA improvement. Additional treatments to PDT including IVI anti-VEGF did not appear to improve visual and anatomical outcomes.

CONCLUSIONS:

Symptomatic CCHs respond generally well to PDT. Patients with younger age (< 50 years), pretreatment BCVA≥ 20/200, and thinner foveal edema are most likely to benefit from this approach.

• Authors: Yeen-Fey Ho, Anne Chao, Kuan-Jen Chen, An-Ning Chao, Nan-Kai Wang, Laura Liu, Yen-Po Chen, Yih-Shiou Hwang, Wei-Chi Wu, Chi-Chun Lai, Tun-Lu Chen
• Journal: PloS one (PLoS One) Vol. 13 Issue 5 Pg. e0197088 ( 2018) ISSN: 1932-6203 [Electronic] United States
• PMID: 29851977 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Topics

• Adult
• Aged
• Choroid Neoplasms (drug therapy)
• Female
• Hemangioma (drug therapy)
• Humans
• Male
• Middle Aged
• Photochemotherapy
• Retrospective Studies
• Treatment Outcome
• Visual Acuity