Diffuse choroidal hemangioma: Ophthalmic outcomes following intensity-modulated radiation therapy.

PURPOSE

To report outcomes in patients treated with low-dose lens-sparing intensity-modulated radiation therapy (IMRT) for diffuse choroidal hemangioma (DCH) associated subretinal (subfoveal) fluid (SRF).

MATERIAL AND METHODS

Retrospective interventional case series. 10 patients (11 eyes) treated with IMRT for diffuse choroidal hemangioma-associated SRF. Resolution of subretinal fluid, tumor regression, and best-corrected visual acuity (BCVA).

RESULTS

The mean age was 9.9 years (range, 0.3-32), with 8 (73%) having exudative retinal detachment in the right eye. The rationale for treatment was the presence of SRF (11 eyes, 100%). At baseline, the maximal height of the tumor was 3.4 mm (range, 1.7-5.3). The mean BCVA in the affected eye was 40 ETDRS letters (range, 5-75). All eyes were treated with IMRT (lens-sparing) at a dose of 20 Gy in 10 fractions. Patients were followed up for an average duration of 7 years (range 6-120 months), with 9 (82%) followed up for more than 2 years. Resolution of SRF was noted in all 11 (100%) eyes, with 6 (55%) eyes showing resolution within 3 months. Tumor response was observed in all eyes 11 (100%) (reduction or stabilization of tumor height), with the mean posttreatment height of 2.0 mm. BCVA improved or remained stable in 10 (91%). Radiation-related complications (cataracts, radiation retinopathy, radiation optic neuropathy) were not observed in any of the treated patients.

CONCLUSIONS

Low-dose lens-sparing IMRT is a highly effective treatment for diffuse choroidal hemangioma. IMRT resolves subretinal fluid, induces tumor regression, and preserves visual acuity in vast majority of cases.