LONG-TERM RESULTS AFTER LOW-DOSE OCULAR IRRADIATION FOR CHOROIDAL HEMANGIOMAS

Aim/background-The most common choice of treatment for choroidal haema ngiomas (CH) in the past has been the employment of scatter photocoagu lation of the surface. This management often requires repetitive treat ment or additional invasive management due to massive exudative detach ment of the retina. The aim of this retrospective study was to investi gate the outcome of the alternative application of low dose external b eam irradiation with high energetic photons on these tumours. Methods- A total absorbed dose of 20 Gy was applied to a total of 51 symptomati c eyes: 36 with a circumscribed CH of the posterior pole and 15 with d iffuse CH as part of the Sturge-Weber syndrome. The indication for tre atment was an exudative retinal detachment including or threatening th e fovea. The mean follow up times in each group were 4.5 and 5.3 years , respectively. Out of a group of 33 patients from whom reliable data could be derived, 17 had symptoms lasting longer than 6 months. Result s-In 23 cases (63.8%) with circumscribed CH complete resolution of the subretinal fluid was achieved; the remaining 13 cases (36.2%) showed residual Germany serous detachment distant to the fovea. The visual ac uity improved by two or more lines in 14 cases (38.9%), remained stabl e in 14 cases (38.9%), and decreased in eight cases (22.2%). The funct ional success was dependent on the lag duration between onset of first subjective symptoms and treatment. The morphological results with dif fuse CH were similar to those of the group of circumscribed CH. The vi sual acuity (VA) at last examination was improved in seven cases (46.6 %); in the remaining eight cases, VA was unchanged or had deteriorated . The poor functional outcome in the latter was mainly attributable to secondary glaucoma. Conclusion-External beam irradiation is a useful and a low invasive therapeutic option for CH. A successful functional outcome is dependent on the time delay between first onset of symptoms and the beginning of therapy, the formation of subretinal fibrosis, a nd also on secondary glaucoma in the case of Sturge-Weber syndrome.