Our results of photodynamic therapy in intraocular tumors

Photodynamic therapy (PDT) is based on the destruction of the target tissue, after a light-sensitive chemical substance is administered intravenously to the body, stimulating this substance with a low-energy light and providing occlusion of the vascular component in the target tissue without damaging the surrounding tissues. Due to its selective response, PDT is used in many different fields of medicine such as ophthalmology, cardiology, dermatology, urology and microbiology. In ophthalmology, PDT was first used in the treatment of age-related macular degeneration. However, its use in different diseases has been reported later. Ocular oncologists, on the other hand, aimed to protect healthy tissues while causing destruction in tumor tissue by causing selective tissue damage with the use of PDT. PDT applications in different tumors such as choroidal hemangioma, choroidal melanoma, choroidal osteoma, vasoproliferative tumor, choroidal metastasis and the results of these applications have been reported. The aim of this study is to evaluate the results and side-effect profile of Photodynamic Therapy using Verteporfin in different types of intra ocular tumors. For the study, the files of the patients who were followed up in Akdeniz University Ophthalmology Department, Ocular Oncology Unit between January 2014 and January 2021 and who underwent Photodynamic Therapy were retrospectively analyzed.15 eyes of 15 patients were included in the study. 9 (60%) of the patients were female and 6 (40%) were male. The mean age of the patients was 47,85±17,02. Mean follow-up time was 33,87±18,84.The mean visual acuity was determined as 1.29±0.98 logMAR in the examinations just before the PDT application. At the end of the follow-up period, the mean visual acuity was calculated as 1.41±1.07 logMAR. While VA increased in 3 (20%) patients and decreased in 5 (33.3%) patients; It was determined that VA value did not change after treatment in 7 (46.7%) patients. The mean lesion diameter before PDT was 6573 ±2115 µm (range; 1500-10000µm). The mean tumor thickness before PDT was 3624 ±1404 µm (range; 600-6000µm). The mean lesion diameter after treatment was 6026±2521 µm (range; 0-9000µm), and the mean tumor thickness after treatment was 2280 ±1740 µm (range; 0-6000 µm). After the FDT , tumor size decreased in 8 (53.3%) patients, increased in 3 (20%) patients, and no change in tumor size was observed in 4 (26.7%) patients. It was observed that visual stabilization and changes in tumor size as a result of the treatment were similar to the literature. Mean IOP values of all patients were 14.06±3.17 mmHg before treatment; after treatment, it was measured as 13.46±1.70 mmHg.After the treatment, geographic atrophy developed in 1 (6.7%) patient, cystoid macular edema developed in 1 (6.7%) patient, Retinal Pigment Epithelium (RPE) and choroidal atrophy developed in 1 (6.7%) patient. As a result, PDT may be a good option in the treatment of intraocular tumors with the chance of selective treatment and successful responses in selected cases.