Single spot photodynamic therapy: High recurrence rate in pa
Circumscribed choroidal hemangioma (CCH) is a relatively rare vascular hamartoma that typically presents in the posterior pole. Although it is a benign tumour, visual acuity can drop as a consequence of a hyperopic shift caused by increasing tumour size within the macula or by leakage, leading to serous retinal detachment and less often intraretinal macular oedema. The study was done to evaluate the long‐term follow‐up of patients with a circumscribed choroidal hemangioma (CCH) treated with limited single spot photodynamic therapy.

An unexpected high recurrence rate of 35% was found with a mean follow‐up time between treatment and recurrence of almost 6 years. With a recurrence, the classical CCH pattern was no longer recognizable on FA or ICG. Signs of leakage were best observed with OCT, and the recurrence could be confirmed with USG. Retreatment with PDT of all recurrences was successful. After a successful initial PDT, the achieved visual acuity (VA) showed a small decrease over time after a mean follow‐up of 11.36 years (range 5.1–15.5 years). During the follow‐up study visit, the OCT revealed a slightly increased thickness of the choroid in 86% of cases at the site of the original tumour, without a clear correlation to the recurrences.

In conclusion, CCH can be successfully treated with PDT. The limited single spot PDT protocol is a safe treatment preserving the VA even after a long follow‐up time. With the relatively high recurrence rate found in this study, we recommend regular follow‐up with OCT every 6 months, especially in the patients with a marginally detectable tumour on USG following PDT treatment.