ABSTRACT
Circumscribed choroidal hemangiomas (CCHs) are relatively rare. We report the response of a symptomatic CCH to photodynamic therapy (PDT). A 70-year-old male presented with blurred vision of the left eye (OS). Best-corrected visual acuity (BCVA) was 20/60 right eye and 20/160 OS. Biomicroscopy revealed bilateral cataracts. Diagnosis of CCH was made fundoscopically for OS and confirmed with optical coherence tomography (OCT). One session of PDT with individualized parameters was administered. After 2 months, anatomical improvement was evidenced with OCT and BCVA was 20/60. After cataract surgery, his BCVA was of 20/25 and remained stable. PDT showed excellent anatomic and visual results after a 2-year follow-up.
Los hemangiomas coroideos circunscritos son relativamente raros. Reportamos la respuesta de uno sintomático con terapia fotodinámica. Un hombre de 70 años presentó visión borrosa en el ojo izquierdo. La mejor agudeza visual corregida fue de 20/60 en el ojo derecho y de 20/160 en el izquierdo. La biomicroscopía demostró catarata en ambos ojos. En el ojo izquierdo se diagnosticó un hemangioma coroideo circunscrito confirmado con tomografía de coherencia óptica. Se administró una sesión de terapia fotodinámica con parámetros individualizados. Dos meses después se observó mejoría anatómica en la tomografía de coherencia óptica, y la mejor agudeza visual corregida fue de 20/60. Después de la cirugía de catarata, la mejor agudeza visual corregida fue de 20/25 y tuvo estabilidad. La terapia fotodinámica mostró excelentes resultados anatómicos y funcionales a los 2 años.
Subject(s)
Choroid Neoplasms/drug therapy , Hemangioma/drug therapy , Photochemotherapy , Aged , Cataract Extraction , Choroid Neoplasms/diagnosis , Hemangioma/diagnosis , Humans , Male , Tomography, Optical Coherence , Treatment Outcome , Visual AcuityABSTRACT
AIM: To compare the effectiveness of intravitreal bevacizumab and subthreshold macular photocoagulation (SMP), for the treatment of non-center involved diabetic macular edema (non-CI DME). METHODS: Prospective, randomized, controlled clinical study included patients with type 2 diabetes, non-CI DME and best-corrected visual acuity (BCVA) of 0.30 logMAR or better. Each eye was randomized into three groups: group 1, monthly intravitreal bevacizumab; group 2, single SMP; group 3, single SMP and monthly bevacizumab. Main outcome measures were BCVA, and macular thickness measured with optical coherence tomography as macular central subfield thickness (CST), macular area of greater thickness (MAGT) and total macular volume (TMV). Results were analyzed after 3mo. RESULTS: A total of 32 eyes were included. Group 3 improved in BCVA (0.19±0.16 to 0.12±0.14 logMAR; P=0.041) and in TMV (7.90±0.57 to 7.65±0.73 mm3; P=0.025). Group 1 improved in MAGT (325±26.26 to 298.20±44.85 µm; P=0.022) and TMV (7.79±0.57 to 7.50±0.56 mm3, P=0.047). Group 2 didn't show significant improvement of any variable. CONCLUSION: The loading phase of bevacizumab as monotherapy or combined with SMP is superior to SMP as monotherapy in providing short-term visual and anatomical improvement in non-CI DME.
