Long-term results after proton beam therapy for retinal papillary capillary hemangioma.
OBJECTIVE
To evaluate the potential benefit and risk of proton beam therapy in the treatment of symptomatic retinal papillary capillary hemangioma.


METHODS
Retrospective interventional case series.


METHODS
This study included patients presenting with symptomatic exudative retinal papillary capillary hemangioma with or without association with von Hippel-Lindau disease. All patients were treated either as a first or a secondary treatment option by proton beam therapy between 2001 and 2009. The minimum follow-up was 30 months.


RESULTS
Eight eyes of 8 patients (3 male and 5 female, with a mean age of 36 years [range 22-80 years]) were treated for symptomatic papillary retinal hemangioma. The median interval between onset of macular edema and proton beam therapy was 1.7 months (range 0.5-3.3 months). The median follow-up period was 84 months (range 32-106 months) between proton beam treatment and last follow-up. Exudation completely resolved in all but 1 patient after 4.2 months on average (range 2.8-7.2 months). Mean visual acuity prior to proton beam irradiation was 0.7 logMAR (0.2 DIN (DIN 58220 norm)) (range 2-0.3 logMAR) and declined to 0.8 logMAR (0.16 DIN; range 2-0.1 logMAR) at last follow-up examination (no statistical significance, P=.071).


CONCLUSIONS
The anatomic outcome after proton beam therapy for retinal papillary hemangioma is convincing, whereas functional outcome may be compromised because of tumor location, long-persisting macular edema, extensive exudation, and poor initial visual acuity. In patients with extended retinal detachment surgical intervention was still necessary. Although proton beam therapy is proven to be a therapeutic option, treatment will remain challenging.
Augenklinik, Charité Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany. Electronic address: ira.seibel@charite.de.
Ira
I
Seibel
Augenklinik, Charité Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany; Berlin Protonen am Helmholtz-Zentrum Berlin für Materialien und Energie, Charité Universitätsmedizin Berlin, Lise-Meitner-Campus, Berlin, Germany.
Dino
D
Cordini
Augenklinik, Charité Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany.
Annette
A
Hager
Augenklinik, Charité Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany.
Aline I
AI
Riechardt
Augenklinik, Charité Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany.
Julian P
JP
Klein
Augenklinik, Charité Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany; Berlin Protonen am Helmholtz-Zentrum Berlin für Materialien und Energie, Charité Universitätsmedizin Berlin, Lise-Meitner-Campus, Berlin, Germany.
Jens
J
Heufelder
Klinik für Radioonkologie und Strahlentherapie, Charité Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany.
Lutz
L
Moser
Augenklinik, Charité Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany.
Antonia M
AM
Joussen
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005451:Fluorescein Angiography; D005500:Follow-Up Studies; D005654:Fundus Oculi; D018324:Hemangioma, Capillary / Q000473:pathology / Q000532:radiotherapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D061766:Proton Therapy / Q000379:methods*; D012160:Retina / Q000473:pathology* / Q000528:radiation effects; D019572:Retinal Neoplasms / Q000473:pathology / Q000532:radiotherapy*; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D014792:Visual Acuity; D055815:Young Adult