A fast protocol for photodynamic therapy in exudative choroidal circumscribed hemangioma: Early laser irradiance after end of verteporfin infusion.

PURPOSE: The aim of the study is to compare the risk of first-line photodynamic therapy (PDT) failure according to the PDT protocol performed in patients with exudative choroidal circumscribed hemangioma (CCH).

METHODS

We retrospectively included patients from 11 European centres in France, Italy and Denmark. Two groups were established: patients treated with Standard Protocol PDT (SP-PDT) and patients treated with a 'Fast' Protocol PDT (FP-PDT), characterised by laser irradiation without delay after the end of the verteporfin infusion (8 min after start of infusion). We analysed groups on the risk of exudative CCH recurrence requiring a second line of treatment, defining the first-line PDT failure.

RESULTS

A total of 111 patients were included in the study: 76 treated with the SP-PDT and 35 with the FP-PDT. First-line PDT failure was observed for 45 patients (59%) in the SP-PDT group and 9 patients (26%) in the FP-PDT group, with a median follow-up of 3.5 [1.7-6.7] years and 2.3 [0.8-3.9] years, respectively. Final best-corrected visual acuity (BCVA) improvement did not differ between groups (p = 0.49). A multivariate survival analysis including initial CCH thickness and initial BCVA was performed over a two-year follow-up period: FP-PDT as first-line treatment was significantly associated with a lower risk of PDT failure [HR = 0.27, 95%CI (0.11-0.65)].

CONCLUSION

FP-PDT shows encouraging results in the treatment of CCHs, as it is associated with a lower risk of PDT failure. It may therefore represent an interesting avenue for optimised PDT parameters, although these results need to be confirmed by randomised trials.