Efficacy of Proton Therapy in Circumscribed Choroidal Hemangiomas Associated with Serous Retinal Detachment

Hannouche, D; Frau, E; Desjardins, Laurence; Cassoux, Nathalie; Habrand, Jean‐Louis; Offret, H

doi:10.1016/s0161-6420(97)30026-8

Cited by 67 publications

(30 citation statements)

References 15 publications

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“…The aim of the treatment is to induce sufficient tumour atrophy with resolution of subretinal fluid and tumour-induced foveal distortion. As compared to previously reported methods of treatment such as argon laser photocoagulation, 2 cryotherapy, 3 TTT, 7 and various forms of radiotherapy, [4][5][6] PDT is superior as it offers a location-specific modality of treating choroidal haemangioma with a potential of sparing overlying retina and retinal vessels. Moreover, it is an outpatient procedure performed under topical anaesthesia and usually only one session of treatment is required.…”

Section: Discussionmentioning

confidence: 92%

“…Since choroidal haemangioma is usually in the posterior pole, it is important to ensure the least amount of damage to the overlying retina to conserve visual acuity. Various modalities have been tried for the treatment of circumscribed choroidal haemangioma, including argon laser photocoagulation, 2 cryotherapy, 3 external beam radiotherapy, 4 proton beam radiotherapy, 5 episcleral plaque radiotherapy, 6 and transpupillary thermotherapy (TTT). 7 All these techniques have been reported with varying degrees of success in stabilizing or improving visual acuity, but the major limitation with all these treatment modalities has been the risk of damage to the overlying retina.…”

Section: Introductionmentioning

confidence: 99%

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Efficacy of photodynamic therapy in circumscribed choroidal haemangioma

Gupta

Singh

Rundle

et al. 2004

Eye

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Purpose To report efficacy of photodynamic therapy (PDT) in the treatment of three cases of juxtafoveal circumscribed choroidal haemangioma. Methods Data on three patients (two primary, and one failed TTT) treated with verteporfin, 6 mg/m 2 given as i.v. infusion over 10 min. Diode laser (690 nm) with an intensity of 600 mW/cm 2 for 83 s (50 mJ/cm 2 ) was applied 5 min after completion of infusion. Overlapping multiple spots (2500 lm) were applied to cover the entire surface of the tumour. The mean pretreatment tumour size was 7 mm (base) Â 2.2 (thickness) mm. Periodic follow-up with ophthalmoscopy, ultrasonography, and angiographic studies was performed. Results All three cases showed complete regression of the tumour with resolution of subretinal fluid, flattening of tumour, and absence of choroidal vasculature on ICG. The visual acuity either improved or remained stable in all three cases. The overlying retinal vessels remained unaffected. There were no ocular or systemic complications. Conclusions PDT is an effective treatment for management of juxtafoveal circumscribed choroidal haemangioma.

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Section: Discussionmentioning

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Efficacy of photodynamic therapy in circumscribed choroidal haemangioma

Gupta

Singh

Rundle

et al. 2004

Eye

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“…In addition to tumor regression, absorption of subretinal fluid has been achieved in 67–100% of cases [14,15,16,17]. Hannouche et al [15] reported visual acuity improvement by 2 lines or more in 8 of 13 patients treated with PBI using a dose of 30 CGE. Retinal reattachment was achieved in all 13 cases.…”

Section: Discussionmentioning

confidence: 99%

“…This is longer than noted in previous reports for both choroidal hemangioma treated with PDT and PBI using surgical localization with tantalum rings. Hannouche et al [15] found resolution of retinal detachment after a mean period of 52 days (approximately 7 weeks) with a range of 30–210 days (approximately 4–30 weeks) in 13 patients treated with PBI. In another series of 17 eyes treated with PBI, Frau et al [16 ]found retinal reattachment after a median period of 1 month (approximately 4 weeks), with a range of 1–12 months (approximately 4–52 weeks).…”

Section: Discussionmentioning

confidence: 99%

“…Previous reports have demonstrated the effectiveness of proton beam irradiation (PBI) for choroidal hemangioma with surgical localization of the tumor using tantalum rings [14,15,16,17]. The physical characteristics of a proton beam – which include minimal scatter, increased dose at the end of the range, and the extremely sharp falloff at the distal end of the beam – make it ideal for localized intraocular irradiation allowing for minimal exposure of surrounding normal intraocular and orbital structures.…”

Section: Introductionmentioning

confidence: 99%

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Proton Beam Irradiation Using a Light-Field Technique for the Treatment of Choroidal Hemangiomas

et al. 2009

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Background/Aims: To describe the clinical outcomes of patients with circumscribed and diffuse choroidal hemangiomas treated by proton beam irradiation using a nonsurgical light-field technique. Methods: A retrospective chart review was performed on a series of 19 patients (19 eyes) with choroidal hemangiomas treated with proton beam therapy between July 1988 and August 2005. Choroidal hemangiomas were treated with proton beam irradiation using a light-field technique and doses ranging from 15 to 30 cobalt Gray equivalents (CGE; CGE = proton Gy × relative biological effectiveness 1.1) in 4 fractions. Patients with at least 6 months’ follow-up were included in the study. Tumor regression, visual acuity, absorption of subretinal fluid, and treatment-associated complications were evaluated by clinical examination and ultrasonography. Results: Visual acuity improved or remained stable in 14 of 18 eyes (78%). Subretinal fluid was initially present in 16 of 19 eyes (84%), and completely resolved in all 16 eyes. Tumor height, as measured by B-scan ultrasonography, decreased in 18 of 19 eyes and remained stable in 1 of 19, as of the last examination. Complications of radiation developed in 9 of 19 eyes (47%) with the total applied dose ranging from 15 to 30 CGE for these 9 eyes. Conclusions: Proton beam irradiation using a light-field technique without surgical tumor localization is an effective treatment option in managing both circumscribed choroidal hemangiomas and diffuse hemangiomas associated with Sturge-Weber syndrome. A total proton dose as low as 15 CGE applied in 4 fractions appears to be sufficient to reduce tumor size, promote absorption of subretinal fluid, and improve or stabilize vision in most patients.

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Photodynamic Therapy for Choroidal Hemangioma Associated With Serous Retinal Detachment

Robertson¹

2002

Arch Ophthalmol

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To describe the clinical findings in 3 eyes with circumscribed choroidal hemangioma before and after treatment with photodynamic therapy. Patients and Methods: In the setting of a tertiary referral center, 2 patients with circumscribed, posteriorly located, choroidal hemangiomas (thicknesses 2.4 and 2.9 mm) contiguous with the superior boundary of the optic nerve and accompanied by serous detachments of the sensory retina extending into the macula were treated with photodynamic therapy using a Zeiss diode laser (692 nm) and a sensitizing dye, verteporfin. A third patient with a circumscribed subfoveal hemangioma (3.9 mm in thickness) and a prominent serous retinal detachment was similarly treated. The tumors were studied with ultrasonography and fluorescein angiography. Visual fields were tested with Goldmann perimetry at follow-up. Results: Following photodynamic therapy, the serous retinal detachments resolved, and the choroidal hemangioma in each of the 3 eyes regressed to a nonmeasurable thickness within 2 to 5 months. The visual acuity improved from 20/50 to 20/20, 20/150 to 20/20, and 3/200 to 20/200 in the respective cases. Two eyes were treated twice. The tumors have not recurred at follow-up visits from 11 to 16 months. Nerve fiber bundle field defects were not demonstrated with Goldmann field testing. Conclusions: Photodynamic therapy seems to be effective in the management of circumscribed choroidal hemangioma. Following photodynamic therapy, the choroidal hemangiomas in 3 eyes were no longer measurable by ultrasonography, and the accompanying serous detachments resolved with improvement in the central visual acuities. Nerve fiber bundle defects were not identified.

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Efficacy of Proton Therapy in Circumscribed Choroidal Hemangiomas Associated with Serous Retinal Detachment

Cited by 67 publications

References 15 publications

Efficacy of photodynamic therapy in circumscribed choroidal haemangioma

Efficacy of photodynamic therapy in circumscribed choroidal haemangioma

Proton Beam Irradiation Using a Light-Field Technique for the Treatment of Choroidal Hemangiomas

Photodynamic Therapy for Choroidal Hemangioma Associated With Serous Retinal Detachment

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