Photodynamic Therapy for Choroidal Metastasis in 8 Cases

Purpose: To determine the efficacy of photodynamic therapy (PDT) in the treatment of choroidal metastasis. Design: Retrospective, interventional case series. Participants: Nine tumors in 8 eyes of 8 patients. Intervention: Photodynamic therapy using verteporfin at a dose of 6 mg/m(2) body surface area and 689 nm diode laser at an intensity of 600 mW/cm(2) for 83 seconds (50 J/cm(2)). Main Outcome Measures: Tumor control and best-corrected visual acuity. Results: Nine choroidal metastases in 8 eyes were treated with 1 (8 tumors) or 2 (1 tumor) sessions of PDT. The mean tumor basal diameter was 7 mm (median, 7 mm [range, 2-13 mm]), and mean tumor thickness was 2.9 mm (median, 2.9 mm [range, 1.6-4 mm]). All 9 tumors were associated with shallow subretinal fluid. After PDT, complete control with resolution of subretinal fluid was achieved in 7 tumors (78%), with mean tumor thickness reduction of 39% (median, 43% [range, 6%-61%]). Two tumors failed to respond to PDT, both requiring plaque radiotherapy. Improvement or stabilization of vision was achieved in 7 eyes. Photodynamic therapy-related complications included intraretinal hemorrhage in 1 eye. Conclusions: Photodynamic therapy can be an effective alternative for the treatment of choroidal metastasis. Financial Disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article. Ophthalmology 2012;119:1218-1222 (C) 2012 by the American Academy of Ophthalmology.