31 patients with CCH and symptoms Underwent PDT IV Verteporfin 6 mg/m 2 689nm laser 15 min laser 50j/cm 2 83 sec exposure 1-4 treatment Follow up 12 month
Primary end point1. Absence of exudative RD at 12 month follow up (FFA,OCT, Ophthalmoscopy) Secondary endpoint1. Visual acuity2. Tumour thickness decrease3. Adverse events
Inclusion criteria1. 18 with CCH height 5 mm and diameter 12 mm2. Exudative RD affecting the fovea3. No cataract within last 2 months Exclusion criteria1. NYHA Class III-IV2. Porphyria3. Liver disease4. Active hepatitis
Results 82.8% 1 session 13.8% 2 sessions 3.4% 3 sessions Visual acuity increased mean 20/60 to 20/ 35 CMO regressed and Exudative RD disappeared in all except 2 cases. CCH thickness decreased from 3 to 1.7 mm Visual fields showed resolution of central scotomas No adverse events
Retrospective study of 14 patients with symptommatic circumscribed choroidal hemangioma who underwent PDT± IVTA Shao Huang, James Fabian etal. Optometery and visual science , 2009.
Symptomatic visual loss Exudative Detachment Macular edema Subfoveal fluid Tumour encroaching to within 2 mm of the fovea.
7.5 mm spot size Overlapping spots 83 sec IVTA (0.1ml of 40 mg/ml) Baseline VA IOP Macular thickness 10 eyes PDT 4 PDT and IVTA
Conclusion Optimal treatment settings remains a matter of debate for CCH Variable number of spots Ranging Spot size (2500-7700µ) Ranging duration (60-83sec) Overlapping vs non overlapping spots Number of treatment sessions