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Abstract
To evaluate the potential benefit and risks of photodynamic therapy (PDT) in the treatment
of papillary capillary hemangioma.
Prospective, noncomparative, interventional case series.
Five patients with solitary capillary hemangioma on the temporal portion of the optic
nerve presenting with exudative decompensation and decrease in visual acuity (VA).
All eyes received a standardized PDT treatment with 6 mg/kg body surface area verteporfin
and application of 100 J/cm(2) light at 692 nm. One to three PDT courses were performed
until resolution of exudation was achieved. A continuous follow-up was provided with
documentation 1 week before and at 4 to 6 weeks, 3 months, and 12 months after the
last treatment application.
Functional parameters included best-refracted VA (Early Treatment Diabetic Retinopathy
Study), and central scanning laser ophthalmoscope (SLO) scotometry and peripheral
(automated perimetry) visual fields; anatomic parameters were presence of retinal
edema or serous detachment (ophthalmoscopy) and tumor size (ultrasonography).
Pretreatment VA levels ranged from 20/40 to 20/800; posttreatment levels ranged from
20/64 to 20/2000. Tumor regression with resolution of macular exudate and serous retinal
detachment was obtained in all eyes. A decline in VA of 1, 3, and 10 lines, respectively,
was documented in three patients. Complications included transient decompensation
of vascular permeability, occlusion of retinal vessels, and ischemia of the optic
nerve.
PDT is successful in reducing tumor size and exudative activity. Vaso-occlusive effects
at the level of the retina and optic nerve compromise the functional benefit. Parameters
proven safe in choroidal neovascularization may be inappropriate in retinal capillary
lesions of the optic nerve.