Photodynamic therapy of symptomatic choroidal nevi

To evaluate the role of photodynamic therapy (PDT) for patients with symptomatic choroidal nevi involving the fovea or located near the fovea with subretinal fluid extending to the fovea. Retrospective review of five patients who underwent PDT for choroidal nevi at two separate centers in Ankara and Barcelona. The mean initial logMAR visual acuity was 0.5 (range: 0 to 1.5). The mean largest tumor base diameter was 3.2 mm (range: 2.1-4.5 mm) and the mean tumor thickness was 1.1 mm (range: 0.7-1.6 mm). The mean number of PDT sessions was 1.6 (range:1-3). The mean final tumor thickness was 1.0 mm (range: 0-1.6 mm) at a mean follow-up of 19 months (range: 12-32 months). The mean final logMAR visual acuity was 0.4 (range: 0-1.5). Subfoveal fluid disappeared or decreased significantly in 4 of 5 eyes (80%) after PDT. PDT led to resolution of subretinal fluid with preservation of visual acuity in many symptomatic choroidal nevi in this study. Careful case selection is important as PDT of indeterminate pigmented tumors may delay the diagnosis and treatment of an early choroidal melanoma and thereby increase the risk for metastasis.