J Korean Ophthalmol Soc.  2017 Mar;58(3):289-295. 10.3341/jkos.2017.58.3.289.

Treatment Outcome of Serous Macular Detachment in Circumscribed Choroidal Hemangioma

Affiliations
  • 1Research Institute for Convergence of Biomedical Science and Technology, Department of Ophthalmology, Pusan National University Yangsan Hospital, Yangsan, Korea. isbyon@pusan.ac.kr
  • 2Medical Research Institute, Department of Ophthalmology, Pusan National University Hospital, Busan, Korea.
  • 3Department of Ophthalmology, Pusan National University School of Medicine, Yangsan, Korea.

Abstract

PURPOSE
To determine the clinical outcome of anti-vascular endothelial growth factor (anti-VEGF) and photodynamic therapy (PDT) for circumscribed choroidal hemangioma (CCH) with serous retinal detachment.
METHODS
The medical records of patients having CCH with serous retinal detachment in macula were retrospectively reviewed. CCH and serous retinal detachment were evaluated via fundus photography, optical coherence tomography, indocyanine green angiography, and ultrasonography.
RESULTS
A total of 9 eyes were enrolled in this study. The average follow-up period was 19.2 months. The mean visual acuity was 0.51 ± 0.52 (logMAR) and the mean maximum diameter and thickness of the tumor were 6,154.4 ± 2,019.9 µm and 2,224.4 ± 862.1 µm, respectively. Of the 6 eyes receiving anti-VEGF (mean number of injections: 3.16) as the first treatment for serous retinal detachment, 5 had sustained or recurred intraretinal/subretinal fluid (IRF/SRF) and needed additional PDT and transpupillary thermotherapy. In the 3 eyes that received PDT (mean number of treatments: 1.3) as an initial treatment, IRF/SRF was completely resolved. Finally, 8 eyes achieved complete resolution of SRF and IRF; however visual recovery was limited.
CONCLUSIONS
PDT, even with a small number of treatments, can alleviate IRF/SRF in CCH, while anti-VEGF did not.

Keyword

Circumscribed choroidal hemangioma; Serous retinal detachment; Photodynamic therapy

MeSH Terms

Angiography
Choroid*
Endothelial Growth Factors
Follow-Up Studies
Hemangioma*
Humans
Hyperthermia, Induced
Indocyanine Green
Medical Records
Photochemotherapy
Photography
Retinal Detachment
Retrospective Studies
Tomography, Optical Coherence
Treatment Outcome*
Ultrasonography
Visual Acuity
Endothelial Growth Factors
Indocyanine Green

Figure

  • Figure 1. Representative case 4 having an exudative retinal detachment in circumscribed choroidal hemangioma (CCH). (A) At the presentation, fundus photograph showed that an orange colored CCH at the supero-nasal macula in the left eye. Indocyanine green angiography and ultrasonography showed CCH at the same location. Optical coherence tomography showed subretinal fluid (SRF) at the macula. The central macular thickness was 542 μ m and visual acuity was 0.4 (logMAR). The maximum diameter and thick-ness of the tumor was 2,840 μ m and 1,210 μ m, respectively. (B) Six months after intravitreal bevacizumab injection, SRF did not change. Visual acuity was 0.4. (C) Two months after photodynamic therapy, SRF disappeared, macualr thickness decreased to 204 μ m and visual acuity increased to 0.1. Exduative retinal detachment did not recur during 9 months follow-up period.

  • Figure 2. Representative case 9 having an exudative retinal detachment in circumscribed choroidal hemangioma (CCH). (A) At the presentation, fundus photograph showed that an orange colored CCH at the infero-nasal macula in the right eye. Indocyanine green angiography and ultrasonography showed CCH at the same location. Optical coherence tomography showed intraretinal and sub-retinal fluid (intraretinal fluid [IRF]/subretinal fluid [SRF]) at the macula. The central macular thickness was 400 μ m and visual acuity was 0.2 (logMAR). The maximum diameter and thickness of the tumor was 7,910 μ m and 2,830 μ m, respectively. (B) Two months after photodynamic therapy, IRF/SRF disappeared, central macular thickness decreased to 220 μ m but visual acuity did not changed. Exudative retinal detachment did not recur during 10 months follow-up period.


Reference

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