Journal List > J Korean Ophthalmol Soc > v.58(3) > 1010719

J Korean Ophthalmol Soc. 2017 Mar;58(3):289-295. Korean.
Published online March 15, 2017.  https://doi.org/10.3341/jkos.2017.58.3.289
©2017 The Korean Ophthalmological Society
Treatment Outcome of Serous Macular Detachment in Circumscribed Choroidal Hemangioma
Jeong Min Kwon, MD,1 Seung Min Lee, MD,1 Han Jo Kwon, MD,2 Sung Who Park, MD,2,3 Ji Eun Lee, MD, PhD,2,3 and Ik Soo Byon, MD1,3
1Research Institute for Convergence of Biomedical Science and Technology, Department of Ophthalmology, Pusan National University Yangsan Hospital, Yangsan, Korea.
2Medical Research Institute, Department of Ophthalmology, Pusan National University Hospital, Busan, Korea.
3Department of Ophthalmology, Pusan National University School of Medicine, Yangsan, Korea.

Address reprint requests to Ik Soo Byon, MD. Department of Ophthalmology, Pusan National University Yangsan Hospital, #20 Geumo-ro, Mulgeum-eup, Yangsan 50612, Korea. Tel: 82-55-360-2592, Fax: 82-55-360-2161, Email: isbyon@pusan.ac.kr
Received September 01, 2016; Revised January 25, 2017; Accepted March 01, 2017.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.


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.

Keywords: Circumscribed choroidal hemangioma; Serous retinal detachment; Photodynamic therapy

Figures


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 µm and visual acuity was 0.4 (logMAR). The maximum diameter and thickness of the tumor was 2,840 µm and 1,210 µm, 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 µm and visual acuity increased to 0.1. Exduative retinal detachment did not recur during 9 months follow-up period.
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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 subretinal fluid (intraretinal fluid [IRF]/subretinal fluid [SRF]) at the macula. The central macular thickness was 400 µm and visual acuity was 0.2 (logMAR). The maximum diameter and thickness of the tumor was 7,910 µm and 2,830 µm, respectively. (B) Two months after photodynamic therapy, IRF/SRF disappeared, central macular thickness decreased to 220 µm but visual acuity did not changed. Exudative retinal detachment did not recur during 10 months follow-up period.
Click for larger image

Tables


Table 1
Patients' characteristics
Click for larger image

Notes

This work was supported by clinical research grant from Pusan National University Yangsan Hospital.

This study was presented as an e-poster at the 115th Annual Meeting of the Korean Ophthalmological Society 2016.

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