Transpupillary thermotherapy for circumscribed choroidal hemangiomas

Abstract

Purpose: Various treatments have been described for circumscribed choroidal hemangiomas. We present our results with transpupillary thermotherapy (TTT) with infrared laser that indicate that the therapy is a new, effective treatment for this pathologic condition.

Design: Noncomparative, prospective, interventional case series.

Participants: The treatment and follow-up of eight eyes of eight patients with circumscribed choroidal hemangiomas are presented. Each case was treated when the visual acuity (VA) decreased because of serous retinal detachment that affected the macula.

Methods: Infrared diode laser was used at 810 nm and power between 800 and 1200 mW with a beam diameter of 2 or 3 mm depending on the diameter of the hemangioma, with 3 to 6 minutes of exposure time.

Main outcome measures: The final VA, the presence of serous subretinal fluid, funduscopic appearance of the tumor, and the degree of hyperfluorescence observed during fluorescein angiography were the main parameters.

Results: In all eight cases, total reabsorption of the serous retinal detachment was achieved after one or repeated applications of TTT. Mild choroidal atrophy and minimal hyperpigmentation of the retinal pigment epithelium were observed in the treated eyes.

Conclusions: TTT can be considered an acceptable therapeutic option for choroidal hemangiomas and serous retinal detachment, and we believe that the role of this therapy will expand in the management of these patients.