Gamma knife radiosurgery for choroidal hemangioma.
OBJECTIVE
Patients with choroidal hemangioma (CH), a benign ocular hamartoma, frequently presents with visual disturbance as a result of exudative retinal detachment (RD), which originates in subretinal fluid accumulation. We report our experience using the Leksell Gamma Knife in the management of symptomatic CH.


METHODS
Seven patients with symptomatic CH (circumscribed form in 3 patients and diffuse form in 4) were treated with the Leksell Gamma Knife at our institution during a 7-year period. All patients presented with exudative RD involving the macula that resulted in severe visual deterioration. The prescription dose to the target margin was 10 Gy in all cases. The mean tumor volume receiving the prescription dose was 536 mm3 (range, 151-1,057). The clinical data were analyzed in a retrospective fashion after a mean follow-up of 34.4 months (range, 9-76).


RESULTS
The resolution of exudative RD was achieved within 6 months, and the visual acuity of the affected eye had improved at the latest follow-up examination (p=.018) in all patients. No recurrence of exudative RD occurred. Thinning of the CHs was observed in most patients; however, symptomatic radiation toxicity had not developed in any of the patients.


CONCLUSIONS
Symptomatic CHs can be safely and effectively managed with Gamma Knife radiosurgery using a marginal dose of 10 Gy.
Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Yun Taek
YT
Kim
Se Woong
SW
Kang
Jung-Il
JI
Lee
D000293:Adolescent; D000328:Adult; D002648:Child; D002830:Choroid Neoplasms / Q000473:pathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006391:Hemangioma / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008266:Macula Lutea; D008297:Male; D016634:Radiosurgery / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D011879:Radiotherapy Dosage; D012163:Retinal Detachment / Q000209:etiology / Q000532:radiotherapy*; D012189:Retrospective Studies; D047368:Tumor Burden / Q000528:radiation effects; D014786:Vision Disorders / Q000532:radiotherapy; D014792:Visual Acuity / Q000528:radiation effects; D055815:Young Adult