title: Ruthenium-106 brachytherapy and intravitreal bevacizumab for retinal capillary hemangioma.
abstract: The purpose of this study is to report a case of retinal capillary hemangioma treated with ruthenium-106 brachytherapy combined with intravitreal bevacizumab. A 58-year-old woman presented with blurred vision in her left eye for 15 days. Best-corrected visual acuity (BCVA) was counting fingers at 3 m in her left eye. Examination showed a peripheral endophytic retinal capillary hemangioma, with associated macular edema and diffuse hard exudates in a macular star pattern. B-scan ultrasonography revealed a solid, highly reflective retinal tumor measuring 7.1 × 7.5 mm in basal dimension and 3.5 mm in thickness. The hemangioma and macular edema were treated with ruthenium-106 brachytherapy (500 Gy) followed 1 month later with an intravitreal injection of 1.25 mg (0.05 ml) bevacizumab. After 10 months of follow-up, examination demonstrated involution of the hemangioma, resolution of the macular edema, less hard exudates, and improvement of BCVA to 20/25. Ruthenium-106 brachytherapy combined with intravitreal bevacizumab was associated with significant involution of the choroidal hemangioma with resolution of the macular edema and improvement in visual acuity.
authors.affiliation: Institute of Ophthalmology, University of Foggia, viale Luigi Pinto, 71100 Foggia, Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Russo
authors.forename: Andrea
authors.initials: A
authors.lastname: Stella
authors.forename: Antonio
authors.initials: A
authors.lastname: Barone
authors.forename: Ingrid U
authors.initials: IU
authors.lastname: Scott
authors.forename: Nicola Delle
authors.initials: ND
authors.lastname: Noci
mesh_terms: D020533:Angiogenesis Inhibitors / Q000008:administration & dosage; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage*; D000068258:Bevacizumab; D001918:Brachytherapy / Q000379:methods*; D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D018324:Hemangioma, Capillary / Q000175:diagnosis / Q000188:drug therapy* / Q000532:radiotherapy*; D006801:Humans; D058449:Intravitreal Injections; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D019572:Retinal Neoplasms / Q000175:diagnosis / Q000188:drug therapy* / Q000532:radiotherapy*; D012429:Ruthenium Radioisotopes / Q000627:therapeutic use*; D041623:Tomography, Optical Coherence; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors; D014792:Visual Acuity
chemical_list: D020533:Angiogenesis Inhibitors; D061067:Antibodies, Monoclonal, Humanized; D012429:Ruthenium Radioisotopes; D042461:Vascular Endothelial Growth Factor A; D000068258:Bevacizumab