Long-Term Therapeutic Outcomes of Photodynamic Therapy-Based or Photocoagulation-Based Treatments on Retinal Capillary Hemangioma

Photomed Laser Surg. 2018 Jan;36(1):10-17. doi: 10.1089/pho.2017.4296. Epub 2017 Oct 25.

Abstract

Background: Retinal capillary hemangioma (RCH) is a rare and refractory eye tumor.

Objective: The aim of this study was to investigate the therapeutic efficacy of two laser-based therapies for RCH, photodynamic therapy (PDT), and focal photocoagulation-based treatment.

Materials and methods: This was a retrospective study. Eight RCH patients (10 eyes) receiving laser treatment and followed up from November 2011 to December 2016 in our hospital were selected and their medical records reviewed. Clinical results and correlations between various clinicodemographic factors and vision outcome were analyzed.

Results: A total of 39 RCH tumor bodies were found and treated. Eleven sessions of PDT and 25 sessions of photocoagulation were administered. Other treatments included five intravitreal injections of antivascular endothelial growth factor or triamcinolone acetonide and one vitreoretinal surgery. After the follow-up period of 54.3 ± 29.8 months, 35 tumor bodies were stable or regressed, and 4 were recurrent. Vision was improved in four eyes, stable in one, and reduced in five relative to baseline. Photocoagulation was more likely to induce tumor bleeding than PDT (4 eyes vs. 1) and to increase subretinal fluid (3 eyes vs. 1). In correlation analysis, subretinal fluid accumulation was predictive of poor vision outcome (r = 0.69, p = 0.03).

Conclusions: Photodynamic- and photocoagulation-based therapies are both reasonably effective against most RCH tumor bodies, but PDT carries lower risks of bleeding and subretinal fluid refraction. Formation of subretinal fluid may predict poor vision outcome in RCH.

Keywords: anti-VEGF therapy; photocoagulation; photodynamic therapy; retinal capillary hemangioma; therapeutic outcomes.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Cohort Studies
  • Female
  • Follow-Up Studies
  • Hemangioma, Capillary / diagnostic imaging
  • Hemangioma, Capillary / drug therapy*
  • Hemangioma, Capillary / pathology
  • Hemangioma, Capillary / surgery*
  • Humans
  • Laser Coagulation / methods*
  • Male
  • Middle Aged
  • Photochemotherapy / methods*
  • Retinal Neoplasms / diagnostic imaging
  • Retinal Neoplasms / drug therapy*
  • Retinal Neoplasms / pathology
  • Retinal Neoplasms / surgery*
  • Retrospective Studies
  • Time
  • Tomography, Optical Coherence / methods
  • Treatment Outcome
  • Visual Acuity