CHOROIDAL HEMANGIOMAS - VISUAL AND ANATOMIC RESULTS OF TREATMENT BY PHOTOCOAGULATION OR RADIATION-THERAPY

Purpose: Choroidal hemangioma is a benign hamartoma that causes accumu lation of subretinal fluid and resultant visual loss, Although photoco agulation can result in resolution of subretinal fluid, some have foun d that recurrence is common and final visual acuity often is poor. The purpose of this study is to evaluate the visual and anatomic results of radiation therapy and photocoagulation in treating patients with vi sual loss from choroidal hemangiomas. Methods: A retrospective review was performed of patients with circumscribed choroidal hemangiomas (CC H) or diffuse choroidal hemangiomas (DCH) treated for visual loss caus ed by accumulation of subretinal fluid. Of 23 patients with CCH, 13 we re treated by photocoagulation, 8 by plaque brachytherapy, and 2 by le ns-sparing external beam radiation therapy (LSRT), All five patients w ith DCH were treated by LSRT. Results: Of patients with CCH treated by brachytherapy, six (75%) of eight had visual acuity of 6/12 or better at 1 year and 8 (100%) of 8 had no subretinal fluid. Of patients with CCH treated by photocoagulation, 5 (38%) of 13 had visual acuity of 6 /12 or better at 1 year and 6 (46%) of 13 had no subretinal fluid, Of patients with CCH treated by LSRT, none of two had visual acuity of 6/ 12 or better at 1 year and one of two had no subretinal fluid. Of the five patients with DCH treated by LSRT, all had complete resolution of subretinal fluid, Two had marked visual improvement and in the other three, vision was stabilized. Conclusions: Plaque brachytherapy is an effective alternative to photocoagulation for treatment of subretinal fluid caused by CCH. Lens-sparing external beam radiation therapy is e ffective treatment in patients with DCH.