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High-dose iodine-125 episcleral brachytherapy for circumscribed choroidal haemangioma
  1. C López-Caballero1,
  2. M A Saornil2,
  3. J De Frutos5,
  4. C Bianciotto3,
  5. Y Muiños2,
  6. A Almaraz4,
  7. F López-Lara5,
  8. I Contreras1
  1. 1Ophthalmology Department, Hospital Ramón y Cajal, Madrid, Spain
  2. 2Intraocular Tumour Unit, Ophthalmology Department, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
  3. 3Carolina Foundation, Madrid, Spain
  4. 4Epidemiology and Preventive Medicine Department, Valladolid University, Valladolid, Spain
  5. 5Radiotherapy Department, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
  1. Correspondence to Dr Maria Antonia Saornil, Department of Ophthalmology, Hospital Clínico Universitario, C/ Ramón y Cajal s/n, Valladolid, Spain; saornil{at}ono.es

Abstract

Aims To evaluate episcleral plaque radiotherapy with high-dose 125I for the treatment of circumscribed choroidal haemangioma (CCH).

Methods A retrospective review was performed of patients treated for CCH between 1995 and 2007. Brachytherapy was performed with ROPES plaques loaded with 125I seeds with a target apex dose of 48 Gy. Main outcome measures were regression of CCH, resolution of retinal detachment, visual acuity changes and frequency of radiation-related complications.

Results Eight patients met the inclusion criteria. Mean tumour base was 11.3 (range 7.8–14.3) mm and mean height was 4.4 (range 2.8–6.5) mm. Six patients had an associated retinal detachment and seven macular exudates or oedema. Mean preoperative visual acuity ranged from no light perception to 0.7. Three patients had received prior argon laser treatment. All patients received one radiation treatment, since no new symptoms due to CCH developed during follow-up (mean 83 (range 23–123) months). Tumour regression was found in all cases. Three patients presented radiation retinopathy and one subretinal fibrosis. Visual acuity remained stable in six patients and decreased two or more lines in two patients.

Conclusions Episcleral brachytherapy led to tumour regression and resolution of non-rhegmatogenous secondary retinal detachments in this case series that included large CCH. Visual stabilisation was achieved in most cases. Given the acceptable rate of side effects detected, 125I episcleral brachytherapy should be considered in large tumours, in tumours with a subfoveal location or extensive subretinal fluid, and in tumours that have failed to respond to other treatments.

  • Brachytherapy
  • choroid
  • choroidal haemangioma
  • iodine-125
  • pathology
  • treatment
  • treatment other

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Footnotes

  • Part of the content of this manuscript was presented at the annual meeting of the European Association for Vision and Eye Research in 2006 (Vilamoura, Portugal).

  • Funding Grant ‘Jose Maria Aguilar Bartolomé’ and grant ‘Carolina’ (Hospital Clinico Universitario, Spain).

  • Competing interests None declared.

  • Ethics approval This study was conducted with the approval of the Institutional Review Board of the Hospital Clinico Universitario, Valladolid, Spain.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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