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LETTER TO EDITOR
Year : 2008  |  Volume : 56  |  Issue : 1  |  Page : 84-85
 

Trans-pupillary thermotherapy for circumscribed choroidal hemangioma


Shri Bhagwan Mahavir Vitreoretinal Services, Sankara Nethralya, 18 College Road, Chennai - 600 006, India

Correspondence Address:
Pukhraj Rishi
Shri Bhagwan Mahavir Vitreoretinal Services, Sankara Nethralya, 18 College Road, Chennai - 600 006
India
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DOI: 10.4103/0301-4738.37586

PMID: 18158419

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How to cite this article:
Rishi P, Sharma T, Chhablani J. Trans-pupillary thermotherapy for circumscribed choroidal hemangioma. Indian J Ophthalmol 2008;56:84-5

How to cite this URL:
Rishi P, Sharma T, Chhablani J. Trans-pupillary thermotherapy for circumscribed choroidal hemangioma. Indian J Ophthalmol [serial online] 2008 [cited 2013 May 19];56:84-5. Available from: http://www.ijo.in/text.asp?2008/56/1/84/37586


Dear Editor,

We read the article by Shukla et al.[1] on "Vitrectomy for circumscribed choroidal hemangioma (CCH) with exudative retinal detachment refractory to transpupillary thermotherapy (TTT)" with interest. We would like to share our experience about a similar case.

We have reported a case of a 13-year-old girl with a large, subfoveal CCH and a total, secondary retinal detachment [Figure - 1].[2] The tumor measured 6.0 mm in height with a base of 14.2 mm × 13.8 mm. At presentation, visual acuity was reduced to bare perception of light. The patient underwent three applications of TTT at zero, five and 10 weeks. At six months after the first session of TTT, the retina was totally re-attached; vision improved to 7/200. The retina remained attached at the last follow-up, three years from presentation with visual acuity improving to 20/40, N6. It is noteworthy that the subfoveal area of the tumor was not directly treated, hence allowing good visual recovery even while successfully arresting the tumor activity [Figure - 2].

Garcia-Arumi et al.[3] also showed that most of the tumors (62.5%) required two or three applications of TTT to obtain occlusion of the tumor vessels. The end point of TTT in treatment of CCH is the resolution of exudative retinal detachment at the fovea and not total tumor destruction. If the subretinal fluid fails to resolve after one treatment, second and third treatment sessions can be applied. Further treatment is not necessary if the exudation from the tumor stops. In the case reported by Shukla et al.[1] TTT was applied only once and then presumed to be refractory to further treatment. Also, it would have been worthwhile to mention the tumor dimensions.

 
   References Top

1.Shukla D, Ramasamy K. Vitrectomy for circumscribed choroidal hemangioma with exudative retinal detachment refractory to transpupillary thermotherapy. Indian J Ophthalmol 2007;55:298-9.  Back to cited text no. 1    
2.Rishi P, Sharma T. Transpupillary thermotherapy for large-sized subfoveal circumscribed choroidal hemangioma. Retina 2006;26:974-6.  Back to cited text no. 2  [PUBMED]  [FULLTEXT]
3.Garcia-Arumi J, Ramsay LS, Guraya BC. Transpupillary thermotherapy for circumscribed choroidal hemangioma. Ophthlmology 2000;107:351-7.  Back to cited text no. 3    


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  [Figure - 1], [Figure - 2]


This article has been cited by
1 Congenital vascular malformations of the retina and choroid
H Heimann, B Damato
Eye. 2010; 24(3): 459-467
[Pubmed]



 

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