Please cite this article in press as: Pinheiro-Costa J, et al. Disappearance of circumscribed choroidal hemangiomas with photodynamic therapy. Photodiagnosis and Photodynamic Therapy (2015), http://dx.doi.org/10.1016/j.pdpdt.2015.02.003 ARTICLE IN PRESS +Model PDPDT-628; No. of Pages 4 Photodiagnosis and Photodynamic Therapy (2015) xxx, xxx—xxx Available online at www.sciencedirect.com ScienceDirect jou rn al hom epage: www.elsevier.com/locate/pdpdt CASE REPORT/RESEARCH LETTER Disappearance of circumscribed choroidal hemangiomas with photodynamic therapy J. Pinheiro-Costa MD a,b,∗ , P. Freitas-Costa a,b , Teresa Braganc ¸a a , F. Falcão-Reis a,c , Ângela M. Carneiro a,c a Department of Ophthalmology, Hospital de São João, Portugal b Department of Anatomy, Faculty of Medicine of University of Porto, Portugal c Department of Sense Organs, Faculty of Medicine of University of Porto, Portugal KEYWORDS Circumscribed choroidal hemangioma; Photodynamic therapy; Spectral-Domain OCT; ICG angiography Case presentation research letter Choroidal hemangioma is a vascular hamartoma that may occur sporadically, in a circumscribed isolated form, or in association with Sturge—Weber syndrome, as a dif- fuse choroidal angiomatosis [1]. Circumscribed choroidal hemangioma (CCH) is almost always unilateral and typically presents in the macular and peripapillary area. Although it is a benign tumor, exudation from the lesion can lead to reti- nal detachment, cystoid macular edema and retinal pigment epithelium (RPE) atrophy, which can lead to significative visual loss [2]. Various therapeutic modalities are available for the treatment of symptomatic CCH, including laser coagulation, external beam radiation, transpupillary thermotherapy, ∗ Corresponding author at: Department of Ophthalmology, Hospi- tal de São João, Al Prof Hernâni Monteiro, 4200-319 Porto, Portugal. Tel.: +351 225 51 2168; fax: +351 225 51 3669. E-mail address: joaopinh@hotmail.com (J. Pinheiro-Costa). intravitreal Anti-Vegf and photodynamic therapy (PDT). While many of these approaches are successful for extra- macular lesions, treatment of macular lesions is more problematic as irreversible foveal damage may occur follow- ing treatment [1]. Therefore, photodynamic therapy (PDT) with verteporfin seems to be the ideal method for the treat- ment of CCH as it can offer site specific tumor destruction while sparing overlying retina and retinal vasculature. Circumscribed choroidal hemangioma presents a charac- teristic behavior on ICG angiography. This tumor typically has an earliest hyperfluorescence achieved at a mean of 28 s, a maximal hyperfluorescence around 220 s and in the late frames all eyes demonstrate a decrease in fluores- cence, with a characteristic washout of the dye [3]. ICG angiography remains one of the main diagnostic tools for the accurate identification and differential diagnosis of a CCH. It is also important in the monitorization of the vascular activity of CCH following treatment. Recently, the Spectral- Domain OCT (SD-OCT) with the EDI technology has allowed a better observation of the choroid, with an improvement of the resolution of the deeper layers of the choroid and the sclera. This method has been applied in the description of the intrinsic optical characteristics of choroidal tumors, and is nowadays another important tool in the differential diag- nosis and follow-up of patients with CCH. On SD-OCT with EDI technology, CCH typically presents a low/medium reflec- tivity and a homogenous signal with large intrinsic spaces, probably of vascular origin [4]. The authors report two cases of CCH with macular exuda- tion that were treated successfully with PDT. In both cases http://dx.doi.org/10.1016/j.pdpdt.2015.02.003 1572-1000/© 2015 Elsevier B.V. All rights reserved.