Optical coherence tomography for evaluation of photodynamic therapy in symptomatic circumscribed choroidal hemangioma

Retina. 2011 Feb;31(2):336-43. doi: 10.1097/IAE.0b013e3181e79887.

Abstract

Purpose: To evaluate the results of photodynamic therapy for circumscribed choroidal hemangioma by optical coherence tomography.

Methods: A retrospective review of 14 eyes with systematic circumscribed choroidal hemangioma receiving photodynamic therapy was evaluated by time-domain optical coherence tomography. Central retinal thickness and foveal photoreceptor layer thickness were assessed, including the status of the junction between the inner and the outer segments of the photoreceptors (IS/OS) in the fovea at the final examination.

Results: The optical coherence tomography findings included 9 eyes (64.3%) with foveal cystoid edema, 9 eyes (64.3%) with subretinal fluid, and 1 eye (7.1%) with foveal thinning. After photodynamic therapy, optical coherence tomography showed absorbed subretinal fluid in 9 eyes and resolved edema in 7 of 9 eyes, with significantly decreased central retinal thickness (440 ± 214 vs. 175 ± 66 μm, P = 0.003). IS/OS lines were observed in 4 eyes, which had a better final visual acuity (VA) (20/40-20/17) and a mean foveal photoreceptor layer thickness of 127.3 ± 5.6 μm. The remaining 10 eyes with an invisible IS/OS line had a poorer final VA and an attenuated foveal photoreceptor layer. The final VA was significantly correlated with initial VA (r = 0.796, P = 0.001) and foveal photoreceptor layer thickness at the final examination (r = -0.832, P = 0.001).

Conclusion: Optical coherence tomography was useful for evaluating VA loss and prognosis in circumscribed choroidal hemangioma. Resolved foveal edema, absorbed subretinal fluid, and preserved photoreceptors contributed to the prognosis of photodynamic therapy for circumscribed choroidal hemangioma.

MeSH terms

  • Adult
  • Choroid Neoplasms / diagnosis*
  • Choroid Neoplasms / drug therapy*
  • Female
  • Fluorescein Angiography
  • Hemangioma / diagnosis*
  • Hemangioma / drug therapy*
  • Humans
  • Macular Edema / physiopathology
  • Male
  • Middle Aged
  • Photochemotherapy*
  • Photosensitizing Agents / therapeutic use
  • Porphyrins / therapeutic use
  • Prognosis
  • Retinal Photoreceptor Cell Inner Segment / pathology
  • Retinal Photoreceptor Cell Outer Segment / pathology
  • Retrospective Studies
  • Subretinal Fluid / physiology
  • Tomography, Optical Coherence*
  • Verteporfin
  • Visual Acuity

Substances

  • Photosensitizing Agents
  • Porphyrins
  • Verteporfin