Bazin L, Gambrelle J
Service d'ophtalmologie, CHU de Brest, 2, avenue Foch, 29609 Brest, France.
J Fr Ophtalmol. 2012 Dec;35(10):798-802. doi: 10.1016/j.jfo.2012.06.015. Epub 2012 Oct 4.
We report a case of symptomatic circumscribed choroidal hemangioma (CCH) treated by photodynamic therapy (PDT) combined with injection of an intravitreal dexamethasone implant (IDI) (Ozurdex(®)).
A 39-year-old woman was referred to our outpatient clinic for a progressive decrease in vision of her right eye, measured at 20/25, due to subretinal exudation (SRE) associated with juxtapapillary CCH. Basal diameter of the CCH was 6mm, and its height was 2mm. Treatment consisted of injection of an IDI followed 15 days later by PDT with a single spot covering the tumor (intensity of 600 mW/cm(2) for 83 seconds [50 J/cm(2)]). Six weeks after PDT, we noted improvement of the vision to 20/20, complete resolution of SRE, and tumor flattening. No side-effects were observed. Anatomic and functional results remained unchanged over 9 months of follow-up.
This case suggests that IDI (Ozurdex(®)) potentiates the effect of PDT with less risk of local side-effects than triamcinolone acetonide. Further evaluation of this protocol remains necessary. Nonetheless, combined treatment with injection of IDI followed 15 days later by PDT for the treatment of symptomatic CCH may prove to be a sound alternative to radiotherapy and may be more efficacious than PDT alone.
