Transpupillary thermotherapy for circumscribed choroidal hemangiomas

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 tr eatment for this pathologic condition. Design: Noncomparative, prospective, interventional case series. Participants: The treatment and follow-up of eight eyes of eight patients w ith circumscribed choroidal hemangiomas are presented. Each case was treate d when the visual acuity (VA) decreased because of serous retinal detachmen t 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 flui d, 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 detac hment was achieved after one or repeated applications of TTT, Mild choroida l atrophy and minimal hyperpigmentation of the retinal pigment epithelium w ere observed in the treated eyes. Conclusions: TTT can be considered an acceptable therapeutic option for cho roidal hemangiomas and serous retinal detachment, and we believe that the r ole of this therapy will expand in the management of these patients. (C) 20 00 by the American Academy of Ophthalmology.