Assuntos
Neoplasias da Coroide/diagnóstico , Neovascularização de Coroide/diagnóstico , Melanoma/diagnóstico , Nevo Pigmentado/diagnóstico , Idoso , Neoplasias da Coroide/complicações , Neoplasias da Coroide/tratamento farmacológico , Neoplasias da Coroide/patologia , Neovascularização de Coroide/complicações , Neovascularização de Coroide/tratamento farmacológico , Neovascularização de Coroide/patologia , Diagnóstico Diferencial , Feminino , Humanos , Injeções Intravítreas , Melanoma/complicações , Melanoma/tratamento farmacológico , Melanoma/patologia , Nevo Pigmentado/complicações , Nevo Pigmentado/tratamento farmacológico , Nevo Pigmentado/patologia , Ranibizumab/administração & dosagem , Descolamento Retiniano/complicações , Descolamento Retiniano/diagnóstico , Descolamento Retiniano/tratamento farmacológico , UltrassonografiaRESUMO
OBJECTIVE: To study the effectiveness and limitations of photodynamic therapy (PDT) as treatment of choice in patients with symptomatic circumscribed choroidal haemangioma. METHODS: A retrospective study was conducted on 16 patients (13 men and 3 women, with mean age of 54.88 years) with circumscribed choroidal haemangioma, who attended our centre and were treated with PDT in the last 7 years. RESULTS: All patients had circumscribed choroidal haemangioma, which caused a decrease in visual acuity (VA) secondary to the presence of intraretinal microcystic oedema or neurosensory detachment. The mean initial VA was 0.23, and the final mean VA after performing PDT was 0.38 (all the VA were measured in decimal scale). It should be noted that patients needed a mean of 1.69 PDT sessions. Three of the patients needed rescue treatment with trans-pupillary thermotherapy, intravitreal injection of anti-vascular endothelial growth factor (ranibizumab, aflibercept) or a dexamethasone intravitreal implant (Ozurdex®). The indication for a change of treatment was the persistence of intraretinal microcystic oedema and/or neurosensory detachment (or incomplete resolution) after 3 PDT sessions. As overall results, 62.5% of patients evolved into anatomical and functional (increase in AV or stability) resolution. CONCLUSIONS: PDT is a straight forward and fast procedure, with a good anatomical and functional response, causing minimal damage to adjacent vessels.