Stereotactic radiotherapy of symptomatic circumscribed choroidal hemangiomas.
OBJECTIVE
To determine feasibility of low-dose stereotactic radiotherapy in the treatment of symptomatic circumscribed choroidal hemangioma.


METHODS
Prospective, noncomparative, interventional case series.


METHODS
Five consecutive patients with perifoveolar and peripapillary circumscribed choroidal hemangioma and visual symptoms from exudative retinal detachment.


METHODS
A dose of 20 Gy was delivered stereotactically with linear accelerator. Tumor dimensions were determined by B-scan ultrasonography.


METHODS
Resolution of subretinal fluid, best-corrected visual acuity, and reduction in tumor height.


RESULTS
Median tumor height at baseline was 2.8 mm (range, 2.0-4.2 mm). Two tumors were subfoveolar, two were juxtafoveolar, and one was extrafoveolar. Cystic macular edema and subretinal fibrosis were present in both eyes with subfoveolar tumor. Exudative retinal detachment resolved within a median of 5 months (response rate, 100%; 95% CI, 48%-100%). Median best-corrected visual acuity was 20/50 (range, 20/22-20/100) at diagnosis and 20/25 (range, 20/20-20/60) 20 months after treatment. Tumor height had decreased a median of 24% (range, 0%-31%) by 6 months and 29% (range, 9%-59%) by 20 months. Secondary retinal pigment epithelial mottling associated with tumor regression occurred in two patients. One eye developed a paracentral scotoma.


CONCLUSIONS
Stereotactic radiotherapy can be targeted precisely enough to induce regression of subretinal fluid from circumscribed choroidal hemangiomas.
Kivelä
Tero
T
Oncology and Vitreoretinal Service, Department of Ophthalmology, Helsinki University Central Hospital, Haartmaninkatu 4 C, PL 220, FIN-00029 HUS, Helsinki, Finland.
Tenhunen
Mikko
M
Joensuu
Timo
T
Tommila
Petri
P
Joensuu
Heikki
H
Kouri
Mauri
M
D000328:Adult; D002830:Choroid Neoplasms / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000532:radiotherapy*; D005240:Feasibility Studies; D005260:Female; D006391:Hemangioma / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000532:radiotherapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011879:Radiotherapy Dosage; D012163:Retinal Detachment / Q000503:physiopathology; D013238:Stereotaxic Techniques; D016896:Treatment Outcome; D014463:Ultrasonography; D014792:Visual Acuity