Photodynamic therapy for symptomatic subretinal fluid related to choroidal nevus

摘要

PURPOSE: The purpose of this article is to evaluate the role of photodynamic therapy (PDT) for symptomatic choroidal nevus with subretinal fluid (SRF) extending to the fovea. METHODS: Retrospective review of the medical records of all patients who underwent PDT for a symptomatic choroidal nevus with SRF. RESULTS: Seventeen patients were included in the study. The mean initial visual acuity was 20/80 (range, counting fingers to 20/20). The mean initial tumor thickness was 1.23 mm (range, 0.66-1.93 mm). All tumors presented at least 2 risk factors for growing (including orange pigment, symptoms, peripapillary location, SRF, and thickness >2 mm). The mean number of PDT sessions was 1.41 (range, 1-3). The mean final visual acuity improved to 20/60 (range, counting fingers to 20/20). Subretinal fluid was reduced in all eyes (100%) and had completely disappeared in 9 eyes (53%) after PDT. Of 9 cases with complete resolution of the SRF, 2 patients (22%) presented recurrence. The mean final tumor thickness increased to 1.24 mm (range, 0.66-2.01 mm) at a mean follow-up of 22.47 months (range, 6-60 months). Tumor thickness increased in 3 eyes (18%) and remained unchanged in 13 eyes (76%), and 1 lesion (6%) shrank down to a flat chorioretinal scar. CONCLUSION: Photodynamic therapy is a good treatment option to reduce SRF in symptomatic choroidal nevus with serous macular detachment. Further growth into melanoma was observed in 18% of cases. Thus, PDT may not allow a good local tumor control. Longer follow-up is required to determine its value in these patients.