Photodynamic therapy for selected, symptomatic choroidal metastases

Purpose To evaluate safety and efficacy of photodynamic therapy (PDT) for the treatment of choroidal metastases. Methods Five cases of selected, symptomatic choroidal metastases were included in this prospective study. Each patient underwent a single-spot standard-fluence PDT with verteporfin (50 J/cm2, 83 sec.). BCVA, fundus photography and optical coherence tomography were performed at baseline and at each follow-up examination (at 1 month and every 3 months thereafter). Fluorescein angiography and indocyanine green angiography were performed at baseline. Results In two patients choroidal metastases were secondary to carcinoid tumors, in two cases to lung and in one case to breast adenocarcinoma. Mean follow-up was 17±6 months. Mean PDT sessions were 1.6 (1-3 sessions). Three patients (60%) showed clinical regression of the treated lesions and in two patients (40%) tumor size remained stable during follow-up. Subretinal fluid resolved in al cases. BCVA increased in four patients (80%) and remained unchanged in one patient (20%). Conclusion Photodynamic therapy appears as an effective and well-tolerated treatment option for the management of selected choroidal metastasis