RUTHENIUM-106 BRACHYTHERAPY IN THE TREATMENT OF CIRCUMSCRIBED CHOROIDAL HEMANGIOMA.
OBJECTIVE
To examine the efficacy and safety of Ruthenium-106 plaque radiotherapy in the treatment of circumscribed choroidal hemangioma.


METHODS
Twenty-one eyes of 21 patients diagnosed with symptomatic circumscribed choroidal hemangioma who underwent Ruthenium-106 plaque radiotherapy were included in the study. Clinical response, ancillary tests finding improvement, and major side effects were evaluated.


RESULTS
From the initial to the 1-year follow-up visits, vision improved in 12 eyes (57%), was stable in 7 eyes (33%), and became worse in 2 eyes (10%). Based on fluorescein angiography and optical coherence tomography, subretinal fluid and cystoid macular edema resolved in all patients. Changes in logarithm of minimum angle of resolution visual acuity (P = 0.038); tumor thickness (P = 0.0001) and largest diameter (P = 0.007) on ultrasonography; and subfoveal thickness on optical coherence tomography (P < 0.0001), were statistically significant between the initial and the 1-year follow-up visits. Side effects as observed during the follow-up period included: radiation-related retinopathy in 5 (24%) eyes, radiation-related papillopathy in 1 eye (5%), and subretinal fibrosis in 2 eyes (10%). Subretinal fibrosis was the only permanent radiation-related side effect.


CONCLUSIONS
Ruthenium-106 plaque radiotherapy is an effective and safe method of treatment for symptomatic circumscribed choroidal hemangiomas. The incidence of permanent visual loss is low with prompt treatment of complications.
Noor Ophthalmology Research Center, Noor Eye Hospital, Tehran, Iran.|Eye Research Center, Rasool Akram Hospital, Iran University of Medical Sciences (IUMS), Tehran, Iran.
Masood
M
Naseripour
Noor Ophthalmology Research Center, Noor Eye Hospital, Tehran, Iran.|Eye Research Center, Rasool Akram Hospital, Iran University of Medical Sciences (IUMS), Tehran, Iran.|Massachusetts Eye Research and Surgery Institution, Waltham, Massachusetts.|Ocular Immunology and Uveitis Foundation, Waltham, Massachusetts.
Arash
A
Maleki
Eye Research Center, Rasool Akram Hospital, Iran University of Medical Sciences (IUMS), Tehran, Iran.
Arezoo
A
Astaraki
Eye Research Center, Rasool Akram Hospital, Iran University of Medical Sciences (IUMS), Tehran, Iran.
Ahad
A
Sedaghat
Department of Biophysics, Tehran University of Medical Sciences (TUMS), Tehran, Iran.
Ramin
R
Jaberi
Massachusetts Eye Research and Surgery Institution, Waltham, Massachusetts.|Ocular Immunology and Uveitis Foundation, Waltham, Massachusetts.
Stacey
S
Lee
Department of Biophysics, Tehran University of Medical Sciences (TUMS), Tehran, Iran.
Zohreh
Z
Azma
Department of Ophthalmology, Rajavithi Hospital, College of Medicine, Rangsit University, Bangkok, Thailand.
Sukhum
S
Silpa-Archa
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001918:Brachytherapy / Q000009:adverse effects / Q000379:methods*; D002648:Child; D002830:Choroid Neoplasms / Q000473:pathology / Q000532:radiotherapy*; D005260:Female; D006391:Hemangioma / Q000473:pathology / Q000532:radiotherapy*; D006801:Humans; D008269:Macular Edema / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012429:Ruthenium Radioisotopes / Q000627:therapeutic use*; D058471:Subretinal Fluid / Q000378:metabolism; D041623:Tomography, Optical Coherence; D014792:Visual Acuity; D055815:Young Adult
D012429:Ruthenium Radioisotopes; C000615522:Ruthenium-106