Clinical Outcomes of Photodynamic Therapy for Choroidal Nevus with Subfoveal Fluid

Abstract

Purpose: To evaluate the outcomes of photodynamic therapy (PDT) for choroidal nevus associated with subfoveal fluid.

Materials and methods: Electronic medical records were reviewed for patients diagnosed with choroidal nevus and treated with PDT at a single center in Seoul, South Korea, from January 2019 to December 2023. Patient demographics, tumor characteristics, and clinical progress following PDT, including changes in foveal subretinal fluid (SRF) height, central subfield thickness (CST), corrected distant visual acuity (CDVA), tumor size, and fluid recurrence, were analyzed.

Results: Seven eyes of seven patients were included; all had SRF involving the foveal center and associated visual symptoms. The median diameter and thickness of tumors were 4.10 mm (range 3.2-5.5 mm) and 0.80 mm (range 0.6-1.4 mm), respectively. All patients received a single PDT session, with a mean follow-up of 20.6 months. Subfoveal fluid decreased in 6 patients (85.7%), with complete resolution in 4 eyes (57.1%); 1 patient showed no significant change after PDT. Consequently, the mean foveal SRF height decreased from 135.9±83.0 µm to 20.3±31.9 µm, and CST from 365.7±82.5 µm to 258.1±52.7 µm. CDVA improved in 1 patient (14.3%), remained stable in 3 (42.9%), and decreased in 2 (28.6%). Three of six patients with reduced subfoveal fluid experienced recurrence at 3 months, 3 months, and 21 months after PDT.

Conclusion: PDT demonstrated noticeable efficacy in reducing subfoveal fluid associated with choroidal nevus within 1 month of treatment. However, in some cases, the effect may be limited in long-term maintenance.