RU-106 BRACHYTHERAPY FOR PERIPHERAL RETINAL CAPILLARY HEMANGIOMA

Objective: This study aimed to evaluate the efficacy and safety of rut henium-106 brachytherapy of large peripheral retinal capillary hemangi omas. Design: A retrospective case series. Participants: In 25 eyes of 24 patients, peripheral capillary retinal hemangiomas were treated. I ntervention: Brachytherapy using 106-ruthenium/106-rhodium plaques was performed. Main Outcome Measures: Eyes were reviewed for hemangioma r egression after brachytherapy, occurrence of retinal detachment, requi rement of additional vitreoretinal surgery, final visual outcome, and final retinal status. Results: Preoperative mean visual acuity of all eyes treated was 20/60, mean hemangioma diameter was 3.8 mm, correspon ding to approximately 2 disc diameters. In 14 eyes, the retina was att ached before surgery, 8 eyes showed an exudative detachment, and 3 eye s showed a traction detachment. Fifteen patients had definite von Hipp el-Lindau syndrome. Twenty-three of 25 hemangiomas could be destroyed by single brachytherapy. In 16 eyes, a favorable outcome could be achi eved. In nine eyes, outcome was unfavorable, characterized by a severe drop in visual acuity, a persisting exudative retinal detachment, or a recurrent traction detachment. In one eye requiring repeated brachyt herapy, irradiation retinopathy occurred. Hemangiomas up to a size of approximately 5.0 mm without preoperative exudative detachment could b e treated safely by brachytherapy, whereas a larger hemangioma size or a pre-existing exudative retinal detachment predisposed to an unfavor able outcome. Conclusion: Solitary peripheral retinal hemangioma can b e ablated effectively by ruthenium-106 brachytherapy. A favorable outc ome can be expected if the hemangioma diameter is 5.0 mm or smaller an d if there is no preoperative exudative retinal detachment.