PHOTODYNAMIC THERAPY FOR VASOPROLIFERATIVE RETINAL TUMORS

Abstract

In Brief Purpose: To report our experience with photodynamic therapy (PDT) with verteporfin for patients with vasoproliferative retinal tumors (VPRTs). Methods: Three patients with VPRTs who presented with macular exudative changes were treated with one session of PDT with 6 mg/m2 body surface area of verteporfin and a light dose of 100 J/cm2 at 689 nm delivered in 166 seconds. Biomicroscopy, fluorescein angiography, indocyanine green angiography, optical coherence tomography, and ultrasonography were performed before treatment and 1 month, 3 months, 6 months, and 1 year after treatment; visual acuity was measured using Early Treatment Diabetic Retinopathy Study criteria. Results: At the 1-year follow-up, all tumors responded with a reduction in size (mean height: pretreatment, 2.96 mm; posttreatment, 1.32 mm), and optical coherence tomography showed complete resolution of macular exudates. For all patients, fluorescein angiography evidenced reduction of leakage from the lesion, and indocyanine green angiography verified nonperfusion of the vascular channels. An improvement in visual acuity (average, 4.7 Early Treatment Diabetic Retinopathy Study letters) was observed. No retreatment was needed. Conclusion: PDT may represent an effective and safe modality of treatment for VPRTs because of its selectivity. Our study supports the application of a light dose of 100 J/cm2, although further studies with larger numbers of cases and longer follow-ups are required. Photodynamic therapy with verteporfin may be a safe and effective therapeutic modality for vasoproliferative retinal tumors located posteriorly, providing improved visual acuity and a marked decrease in tumor dimensions 1 year after treatment.