CO-60 TREATMENT OF CHOROIDAL HEMANGIOMAS

PURPOSE: We investigated the therapeutic possibilities of gamma brachy therapy to improve the final functional results of eyes with choroidal hemangiomas, which are benign vascular tumors that can induce progres sive impairment of visual acuity. METHODS: We treated 41 patients with choroidal hemangioma with cobalt-60 applicators, The lesions consiste d of 39 circumscribed hemangiomas and two diffuse hemangiomas in patie nts with Sturge-Weber syndrome, Before treatment, visual acuity in the affected eye was 20/200 in ten patients, 20/200 to 20/50 in 17 patien ts, 20/40 to 20/25 in 11 patients, and 20/20 in three patients, All pa tients were symptomatic, The macula was infiltrated by the tumor in 12 eyes (29.3%), There was retinal detachment in 40 eyes (97.6%), cystoi d edema in ten eyes (24.4%), subretinal fibrosis in eight eyes (19.5%) , and areolar atrophy in two eyes (4.9%). RESULTS: After treatment, th e retina was reattached in all eyes, and the tumor progressively trans formed into a flat scar, The postirradiation macular lesions that we i dentified were pigment migrations in the macular region, subretinal fi brosis, and an areolar atrophic scar, We correlated the functional res ults at two, five, and ten years after treatment with the initial visu al acuity, and with pre-existing and posttreatment macular lesions. CO NCLUSIONS: Our results suggest that radiotherapy is a valuable therape utic modality for choroidal hemangiomas, particularly in hemangiomas t hat involve the macula, and for tumors associated with bullous retinal detachment.