Transpupillary thermotherapy for circumscribed choroidal hemangioma: clinical profile and treatment outcome.

BACKGROUND AND OBJECTIVE

To report the outcome of treating circumscribed choroidal hemangioma (CCH) using transpupillary thermotherapy (TTT).

PATIENTS AND METHODS

An infrared diode laser was used at 810 nm with a median spot size of 2.5 mm, power of 550 mW, and duration of 6.5 minutes; the median number of sittings was two. TTT spared the center of the macula when CCH involved the fovea.

RESULTS

The mean age was 36 years (range: 13 to 63 years). CCH was subfoveal in 37.5% of the eyes and exudative retinal detachment was evident in all eyes. The tumor dimensions included thickness (median: 4.05 mm; range: 2.2 to 9.1 mm), horizontal diameter (median: 11 mm; range: 6 to 17.7 mm), and vertical diameter (median: 9.4 mm; range: 5.9 to 15.8 mm). After TTT, visual acuity improved in 44%, was maintained in 37%, and worsened in 19% of eyes. Likewise, tumor regression was achieved in thickness, vertical, and horizontal diameter in proportion of 20%, 15%, and 11%, respectively. The exudative retinal detachment resolved in 94% of eyes at the last follow-up. The median follow-up was 9.5 months.

CONCLUSION

Macula-sparing TTT was effective in causing regression of CCH and resorption of associated exudative retinal detachment, and helped in preserving or improving vision in 81% of treated eyes.