Polypoidal choroidal vasculopathy following photodynamic therapy for choroidal hemangioma.

PURPOSE: To report a case of circumscribed choroidal hemangioma (CCH) that responded to photodynamic therapy (PDT) but 3 years later developed polypoidal choroidal vasculopathy (PCV) with exudative retinopathy.

METHODS

Case report.

RESULTS

A 59-year-old woman with a juxtapapillary CCH in her left eye was treated with a single 83-second, 7.5 mm PDT laser spot at 689 nm (50 J/cm2) 15 minutes after the injection of intravenous verteporfin (6 mg/m2). Three years later, the patient presented with photopsia in her left eye. Fundus examination of the left eye showed CCH regressed completely to a flat atrophic scar. There was diffuse macular edema and exudative retinopathy along the inferotemporal vascular arcade. On indocyanine green angiography, there were hyperfluorescent dilated choroidal vessels inferior to the foveola with late staining and leakage consistent with PCV. Hypofluorescence superior and nasal to the optic disc at the site of the treated hemangioma, consistent with choroidal ischemia, was observed. She was treated with 1.25 mg (0.05 cc) intravitreal bevacizumab. After 21 months of follow-up, the exudative retinopathy and macular edema completely regressed.

CONCLUSIONS

PDT is an effective treatment for CCH. Side effects of PDT for CCH are rare but include PCV.