Overlapping Spots of Photodynamic Therapy for Treatment of Choroidal Hemangioma in Sturge-Weber Syndrome: A Case Report.

IF 0.5 Q4 OPHTHALMOLOGY Case Reports in Ophthalmology Pub Date : 2024-04-30 eCollection Date: 2024-01-01 DOI:10.1159/000535948
Alex Y Pai, Michael M Han, Sameh Mosaed, Mohammad Riazi Esfahani
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Abstract

Introduction: Photodynamic therapy (PDT) has shown substantial benefit in the treatment of choroidal hemangioma (CH) in recent years. This report describes the use of PDT with overlapping spots in a patient with Sturge-Weber syndrome (SWS) and large circumscribed CH.

Case presentation: A 9-year-old girl with SWS and a history of glaucoma in her left eye was referred to a retina clinic for possible macular changes. Examination revealed decreased vision in the left eye, pigmentary changes in the macula, and choroidal thickening in the posterior pole. After being lost to follow-up for 2 years, the patient returned with further vision deterioration with best-corrected visual acuity (BCVA) of 20/150 and new subretinal fluid (SRF). Imaging findings were consistent with a diagnosis of CH and SRF. PDT with verteporfin was initiated on the entire area with multiple overlapping spots, resulting in resolution of SRF and improvement in visual acuity and choroidal contour. At 18-month post-treatment, the patient's BCVA was 20/25 with no recurrence of SRF or increased choroidal thickening. Significant pigmentary changes and subretinal hyper-reflective material were observed in the OCT of the treated area.

Conclusion: Multiple overlapping laser spots of PDT can result in longstanding regression of large circumscribed CH in a patient with SWS with excellent final visual acuity. However, significant subretinal changes may also result following this method of treatment.

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光动力疗法治疗 Sturge-Weber 综合征脉络膜血管瘤的重叠点:病例报告。
导言:近年来,光动力疗法(PDT)在治疗脉络膜血管瘤(CH)方面取得了显著疗效。本报告介绍了在一名患有 Sturge-Weber 综合征(SWS)和大面积环形脉络膜血管瘤的患者身上使用重叠光斑的光动力疗法的情况:病例介绍:一名 9 岁女孩患有 SWS,左眼有青光眼病史,因可能出现黄斑病变而被转诊至视网膜诊所。检查发现左眼视力下降,黄斑部有色素性改变,后极部脉络膜增厚。在失去随访两年后,患者再次复诊,视力进一步下降,最佳矫正视力(BCVA)为20/150,并出现新的视网膜下积液(SRF)。影像学检查结果与 CH 和 SRF 的诊断一致。对整个区域的多个重叠点使用verteporfin进行光导治疗,结果SRF消退,视力和脉络膜轮廓得到改善。治疗后 18 个月,患者的 BCVA 为 20/25,SRF 没有复发,脉络膜也没有增厚。治疗区域的 OCT 观察到明显的色素性变化和视网膜下高反射物质:结论:PDT 的多个重叠激光点可使 SWS 患者的大面积环形 CH 长期消退,且最终视力极佳。然而,这种治疗方法也可能导致视网膜下的明显变化。
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来源期刊
CiteScore
0.90
自引率
0.00%
发文量
129
审稿时长
12 weeks
期刊介绍: This peer-reviewed online-only journal publishes original case reports covering the entire spectrum of ophthalmology, including prevention, diagnosis, treatment, toxicities of therapy, supportive care, quality-of-life, and survivorship issues. The submission of negative results is strongly encouraged. The journal will also accept case reports dealing with the use of novel technologies, both in the arena of diagnosis and treatment. Supplementary material is welcomed. The intent of the journal is to provide clinicians and researchers with a tool to disseminate their personal experiences to a wider public as well as to review interesting cases encountered by colleagues all over the world. Universally used terms can be searched across the entire growing collection of case reports, further facilitating the retrieval of specific information. Following the open access principle, the entire contents can be retrieved at no charge, guaranteeing easy access to this valuable source of anecdotal information at all times.
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