ALTERNATIVE MANAGEMENT OF CIRCUMSCRIBED CHOROIDAL HEMANGIOMA USING INTRAVITREAL METOPROLOL

The authors describe a novel off-label treatment for circumscribed choroidal hemangioma with associated subretinal fluid because the currently available therapeutic options have yet allow patients to retain functional vision if tumor is located in the macula. Background/Purpose: To describe a patient with visually symptomatic circumscribed choroidal hemangioma (CCH) treated successfully with intravitreal beta‐blocker. Methods: This is an interventional single case report of a 63 year‐old man with a juxtafoveal CCH and extensive subretinal fluid (SRF) unsuccessfully treated with intravitreal anti‐VEGF. Off‐label intravitreal use of metoprolol (50μg/0.05 ml) was then performed. Main outcome measures were resolution or decreased subretinal fluid on OCT, visual stability or improvement, lack of retinal/ocular toxicity. Results: Following 2 intravitreal injections of metoprolol (1 month apart), significant response was observed with decrease of SRF and visual improvement to 20/400 during a 9‐week follow‐up after the injections. Conclusion: These preliminary findings suggest that intravitreal metoprolol can be a safe alternative treatment for patients with CCH. This off‐label therapy could represent another option for patients with this condition.