PMC3617536_01
(a) Juxtapapillary retinal hemangioblastoma with adjacent lipid exudation. Note minimal lipid exudation in the papillomacular bundle region (b) Foveal contour is normal before photodynamic theraphy (PDT) (c) OCT performed 1 day after PDT shows retinal edema and subretinal fluid under the foveola (d) Three weeks after PDT there is complete reabsorption of intraretinal and subretinal fluid. There are a few focal intraretinal optically dense juxtafoveal deposits consistent with ophthalmoscopically visible lipid exudates
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F1
An asymptomatic 61-year-old female with a 1.5 mm juxtapapillary retinal hemangioblastoma OD showed progressive retinal edema despite three prior off-label intravitreal bevacizumab injections (1.5 mg) [Figures 1a and b]. Optical coherence tomography (OCT) showed extension of retinal edema into fovea [Figure 1c]. There was spontaneous recovery of BCVA to 20/25 and complete resolution of macular edema 3 weeks after PDT [Figure 1d].
PMC3617536_02
(a) Partially pigmented retinal astrocytoma (needle biopsy proven) with lipid exudation at the superior, inferior, and nasal margins extending into the fovea, forming a foveal star (b) OCT before PDT reveals moderate intraretinal cystoid edema at the fovea (c) Three days after PDT there is increased subretinal fluid (d) Four months later, there is complete reabsorption of intraretinal and subretinal fluid leaving retinal atrophy
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F2
Three years after PDT, BCVA decreased to 20/60 due to recurrent macular edema [Figures 2a and b] and she underwent a second standard fluence PDT with verteporfin. On examination, the BCVA was 20/80 and OCT showed increased subretinal fluid at the fovea [Figure 2c]. Three weeks later BCVA improved to 20/60 and 4 months later best corrected visual acuity was 20/20 with complete resolution of macular edema and subfoveal fluid [Figure 2d].
PMC3617536_03
(a) Color fundus photograph showing small amelanotic choroidal melanoma with documented growth (b) OCT shows normal fovea before PDT (c) Eleven days after PDT, neurosensory retinal detachment extending under the fovea is evident (d) Three months after PDT, subretinal fluid has completely disappeared and foveal contour has returned to normal
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F3
A 62-year-old female with visual acuity of 20/20 and an enlarging amelanotic choroidal melanoma in her left eye (OS) measuring 7 mm in basal dimension and 2.7 mm in thickness [Figures 3a and b] was treated with PDT. OS and 11 days later, the best corrected visual acuity was measured at 20/200. OCT confirmed subretinal fluid extending from the treated melanoma into the foveal region [Figure 3c]. The vision improved without treatment 1 month after PDTand 3 months later there was complete resolution of subretinal fluid with visual acuity of 20/20 [Figure 3d].